Eric R. Hansen, D.o., Professional Corporation
NPI #1801937479 in Hesperia, California
Provider Information
- NPI Number
- 1801937479
- Entity Type
- Organization
- Organization Name
- Eric R. Hansen, D.o., Professional Corporation
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- MEDVANTX, INC
- Primary Specialty
- Non-Pharmacy Dispensing Site
- Enumeration Date
- Feb 8, 2007
- Last Updated
- Oct 17, 2012
Practice Location
- Address
- 15888 MAIN ST
- Address 2
- 112B
- City
- Hesperia
- State
- California
- ZIP Code
- 92345-3452
- Phone
- (760) 947-0727
Authorized Official
- Name
- KENNY HEINE
- Title
- DIRECTOR OF OPERATIONS
- Phone
- (858) 625-2990
Specialties & Taxonomy Codes
| Specialty |
|---|
| Non-Pharmacy Dispensing Site |
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