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Individual

DR. JOHN C HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3030 CHILDRENS WAY, #112, SAN DIEGO, CA 92123
(858) 495-0500
(858) 560-4279
Mailing address
3860 CALLE FORTUNADA, STE 200, SAN DIEGO, CA 92123
(858) 636-4300
(858) 636-4319

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G68382
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
G68382
MD LICENSE
CA
Enumeration date
01/30/2006
Last updated
02/04/2011
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