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Organization
ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION
Active
Organization
ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC R HANSEN D.O. (C.E.O.)
(760) 948-8470
Entity
Organization
Contact information
Practice address
14575 MAIN ST, HESPERIA, CA 92345-3322
(760) 948-8470
(760) 947-6219
Mailing address
14575 MAIN ST, HESPERIA, CA 92345-3322
(760) 948-8470
(760) 947-6219
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20A8138
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX81380
—
CA
01
—
DC1926
RAILROAD MEDICARE
CA
Enumeration date
03/27/2007
Last updated
09/24/2015
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