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Individual

DR. PAUL ROBERT HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
1310 JOHNSON LANE, MARE ISLAND, VALLEJO, CA 94592
(804) 754-6118
Mailing address
6576 FRIARS RD, APT. 105, SAN DIEGO, CA 92108-1000
(804) 754-6118

Taxonomy

Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
63493
CA

Other

Enumeration date
09/30/2010
Last updated
10/05/2010
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