CHAD RUSSELL HANSEN

SAN DIEGO, CA
NPI1588941660
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2011-11-03
Last Update Date2011-11-03
Business Address
-- CHAD RUSSELL HANSEN IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 520-289-6568
Mailing Address
-- CHAD RUSSELL HANSEN IDC
34101 FARENHOLT AVE
SAN DIEGO, CA 92134-7000
Phone number: 520-289-6568