Chad Russell Hansen IDC

NPI 1588941660 - Military Health Care Provider - 1710I1002X

NPI Details
NPI 1588941660
Gender Male
Enumeration Date 11/03/2011
Last Updated 11/03/2011
Entity Type Individual
Active Over 5 years ago
Practice Location
34101 FARENHOLT AVE
SAN DIEGO CA, 92134-7000, US
Phone (520) 289-6568
Fax
Business Location
34101 FARENHOLT AVE
SAN DIEGO CA, 92134-7000, US
Phone (520) 289-6568
Fax
Toxanomy
Taxonomy Code 1710I1002X
License State
License Number
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According to our database, Chad Russell Hansen IDC NPI is 1588941660, taxonomy code is 1710I1002X Chad Russell Hansen IDC physically located at 34101 Farenholt Ave, San Diego CA, 92134-7000. NPI Number Chad Russell Hansen IDC has the Individual type.

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1588941660 NPI number is provided on an as is basis without warranty of any kind. 1588941660 is maintained by the National Plan & Provider Enumeration System. The contents of Chad Russell Hansen IDC are for informational purposes only.