# THOMAS A. HANSCOM, MD A MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1134306996
- **Authorized official:** MISS JENNIFER R RANDALL (BILLING MANAGER)
- **Authorized official phone:** (310) 829-3303

## Contact information

- **Practice address:** 2021 SANTA MONICA BLVD STE 720E, SANTA MONICA, CA 90404-2223
- **Practice address phone:** (310) 829-3303
- **Mailing address:** 2021 SANTA MONICA BLVD STE 720E, SANTA MONICA, CA 90404-2223
- **Mailing address phone:** (310) 829-3303

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/23/2008
- **Last updated:** 01/24/2008