Active NPI
Ronald Philip Hattis, MD MPH
- Public Health & General Preventive Medicine Physician
- Redlands, CA
National Provider Identifier
1003868142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- A-23473
- Practice address
- 1233 Friar LN
Redlands, CA 92373-5773 - Phone
- (909) 793-2524
- NPI assigned
- May 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | A-23473 | CA | Primary |
| Family Medicine Physician | 207Q00000X | A-23473 | CA |
Addresses
Primary practice location
1233 Friar LN
Redlands, CA 92373-5773
Mailing address
1233 Friar LN
Redlands, CA 92373-5773
Phone (909) 793-2524
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A-23473 | CA | MD | Family Medicine Physician |
| 23473 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314144000000",
"number": "1003868142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1233 FRIAR LN",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735773",
"telephone_number": "909-793-2524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 FRIAR LN",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923735773",
"telephone_number": "909-793-2524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HATTIS",
"first_name": "RONALD",
"middle_name": "PHILIP",
"name_prefix": "Mr.",
"credential": "MD MPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2011-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "CA",
"license": "A-23473",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CA",
"license": "A-23473",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.