Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN1001X | Nutrition | DC18439 | CA |
N | 111NR0200X | Radiology | DC18439 | CA |
N | 213ER0200X | Radiology | DC18439 | CA |
N | 111NS0005X | Chiropractic Sports Physician | DC18439 | CA |
NPI | 1427139625 |
---|---|
Provider Name | Dr. Jeffrey S Hansen |
First Address | Yorba Linda, CA 92886-6901 |
Second Address | Yorba Linda, CA 92886-4179 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
18439 | (02) | CA |