1760407498

Everything you always wanted to know about DR. HANSEN A LAWRENCE M.D. but were afraid to ask.

DR. HANSEN A LAWRENCE M.D.

You can also download the this 1760407498 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. HANSEN A LAWRENCE M.D.
Gender:
Male
Enumeration date:
2006-07-13
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
00G625380 Medicaid none CA
WG62538A Medicare ID-Type Undpecified none CA
F46596 Medicare UPIN none CA

Taxonomies

Taxonomy State License Number Primary?
207ZN0500X Neuropathology CA G62538 X
207ZP0102X Anatomic Pathology & Clinical Pathology CA G62538 X

Phone Numbers

Type Number
Practice Location Address Telephone Number 6195435764
Mailing Address Telephone Number 6197581916
Mailing Address Fax Number 8585346232

Addresses

Type Address City State Postal Country
Mailing Address 960 ALBION ST SAN DIEGO CA 92106 CA
Practice Location Address 200 W ARBOR DR SAN DIEGO CA 92103 CA

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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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