Doctor Name: | VERNAL MARTIN HANSEN |
NPI Number: | 1871664540 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | G34639 |
Business Practice Address: | 2557 Chino Hills Parkway Suite A Chino Hills, CA - 91709 |
Business Phone Number: | 9093934334 |
Business Fax Number: | 9093934330 |
Mailing Address: | 2557 Chino Hills Parkway, Suite A CHINO HILLS |
State: | CA |
Postal Code: | 91709 |
Phone Number: | 9093934334 |
Fax Number: | 9093934330 |
NPI Enumeration Date: | 11/13/2006 |
NPI Last Update Date: | 03/30/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | G34639 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |