Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0401X | Internist - Addiction Medicine | 170233 | NY |
N | 207RA0401X | Internist - Addiction Medicine | A46120 | CA |
N | 207RA0401X | Internist - Addiction Medicine | MD60665946 | WA |
NPI | 1063589935 |
---|---|
Provider Name | Hans C. Geisse |
First Address | Riverside, CA 92505-3043 |
Second Address | Riverside, CA 92505-3043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 09/06/2021 |