Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | G072969 | CA |
NPI | 1073835617 |
---|---|
Provider Name | Dr. Jean Marie Hanley |
First Address | Manhattan Beach, CA 90266-4036 |
Second Address | Los Angeles, CA 90033-1083 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2010 |
Last Update Date | 24/02/2010 |