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Individual

LAUREL P HANSCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G69913
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G69913
BLUE SHIELD OF CA
CA
05
00G699130
CA
01
30098802
RR MC
CA
Enumeration date
06/07/2006
Last updated
10/18/2007
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