Individual
MARILEE ANN HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 S MANCHESTER AVE STE 600, ORANGE, CA 92868-3222
(714) 456-2911
Mailing address
200 S MANCHESTER AVE STE 300, ORANGE, CA 92868-3219
(714) 456-8888
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
36557
MN
207V00000X
Obstetrics & Gynecology Physician
Primary
G76967
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0703002
MEDICA
MN
01
—
122M9HA
BLUE CROSS
MN
05
—
892930100
—
MN
Enumeration date
06/24/2005
Last updated
01/28/2025
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