Individual
CHARLENE HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 21ST ST, SACRAMENTO, CA 95811-5216
(916) 443-3299
Mailing address
1500 21ST ST, SACRAMENTO, CA 95811-5216
(916) 443-3299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
168946
CA
207R00000X
Internal Medicine Physician
31508
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000R7592
—
NM
05
—
417198
—
AZ
Enumeration date
08/19/2006
Last updated
03/25/2022
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