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1073071593
DERREK DEAN HANSON
SAN DIEGO, CA
NPI
1073071593
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2019-03-04
Last Update Date
2019-03-04
Business Address
DERREK DEAN HANSON IDC
34101 FARENHOLT AVE BLDG 14
SAN DIEGO, CA 92134-7000
Phone number: 619-532-7968
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Mailing Address
DERREK DEAN HANSON IDC
10297 WALDRON WAY
SAN DIEGO, CA 92124-3218
Phone number:
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