Individual
NICOLE HANGSTERFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Mailing address
6195 LUSK BLVD STE 250, SAN DIEGO, CA 92121-3715
(858) 859-1188
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA55858
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
085.005922
PHYSICIAN ASSISTANT LICENSE
IL
Enumeration date
04/08/2015
Last updated
12/05/2022
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