Individual
DR. DANIEL WAYNE HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
NAVAL HOSPITAL, ATTN PROFESSIONAL AFFAIRS, BLDG 1145, STURGIS STREET, TWENTYNINE PALMS, CA 92278-8250
(760) 830-2190
Mailing address
1068 SYCAMORE LN, SAN JACINTO, CA 92582-3882
(951) 654-8779
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G56684
CA
Other
Enumeration date
12/16/2005
Last updated
07/08/2007
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