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Organization

MICHAEL W HANSEN OD INC

Active
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Organization

MICHAEL W HANSEN OD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL HANSEN OD (OWNER)
(310) 321-6990
Entity
Organization

Contact information

Practice address
2101 ROSECRANS AVE, STE 1215, EL SEGUNDO, CA 90245-4749
(310) 321-6990
Mailing address
2101 ROSECRANS AVE, STE 1215, EL SEGUNDO, CA 90245-4749
(310) 321-6990

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT11354TPL
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPT11354TPL
LICENSE
CA
Enumeration date
01/15/2014
Last updated
01/15/2014
About Stedi
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