Individual
MARK HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
207 1ST ST, SAN RAFAEL, CA 94901-3739
(415) 760-9222
Mailing address
17 CUSHING AVE, SAN RAFAEL, CA 94903-2807
(415) 760-9222
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
05/11/2026
Last updated
05/11/2026
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