Provider Demographics
NPI:1609299395
Name:HAID, JAMES (RPH)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HAID
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49908 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-9720
Mailing Address - Country:US
Mailing Address - Phone:760-771-4524
Mailing Address - Fax:760-777-4269
Practice Address - Street 1:49908 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-9720
Practice Address - Country:US
Practice Address - Phone:760-771-4524
Practice Address - Fax:760-777-4269
Is Sole Proprietor?:No
Enumeration Date:2014-01-30
Last Update Date:2014-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49308183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist