Organization
CARLSON, HANSEN, KWON-HONG, MDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M CARLSON M.D. (MANAGING PARTNER)
(209) 549-9900
Entity
Organization
Contact information
Practice address
1213 COFFEE RD, SUITE A, MODESTO, CA 95355-4229
(209) 549-9900
Mailing address
5101 MESA DR, OAKDALE, CA 95361-7858
(209) 848-8903
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G27090
CA
Other
Enumeration date
10/17/2006
Last updated
08/22/2020
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