Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | C53950 | CA |
Y | 2080P0214X | Pediatric Pulmonologist | C53950 | CA |
NPI | 1235126004 |
---|---|
Provider Name | Dr. James S Hagood |
First Address | San Diego, CA 92123-4802 |
Second Address | San Diego, CA 92123-2758 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2005 |
Last Update Date | 10/11/2011 |