Abraham Hagos, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA18390 Issued in CA

Practice address

14375 Nason St
Suite 101
Moreno Valley, CA 92555-4729

Phone

(951) 486-4546

Fax

(951) 486-4295

NPI assigned

Sep 17, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348099200000",
    "number": "1558611673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14375 NASON ST",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14375 NASON ST",
            "address_2": "SUITE 101",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554729",
            "telephone_number": "951-486-4546",
            "fax_number": "951-486-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGOS",
        "first_name": "ABRAHAM",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-17",
        "last_updated": "2012-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA18390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava Hacopian, MD
• Zaidoon M Hadadeen, DDS
• Tina Haeri
• Mark Haft, DO
• Margina Haggard
• Kevin Hahn
• Tasnia Haider
• Leilani Haith, RN
• Galust Gary Halajyan, MD
• Theresa Ann Halcon

• Medical Physician Assistant in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.