ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION (NPI# 1801937479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801937479 |
| Entity Type | Organization |
| Organization Name | ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION |
| Other Organization Name | ERIC R. HANSEN, DO |
| Practice Address |
15888 Main St 112b Hesperia CA 92345-3452 |
| Mailing Address |
5626 Oberlin Dr Suite 110 San Diego CA 92121-1705 |
| Practice Telephone | 7609470727 |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | KENNY HEINE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 8586252990 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDVANTX, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | 20A8138 | CA | Suppliers |
| Other Name | Type Code |
|---|---|
| Eric R. Hansen, DO | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912025958 | Eric R. Hansen, D.o., Professional Corporation | Family Medicine | 14575 Main St, Hesperia, CA 92345-3322 | 2007-03-27 |
| Street Address |
15888 MAIN ST 112B |
| City | HESPERIA |
| State | CA |
| Zip Code | 92345-3452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003897075 | Jintau Ernest Two | Optometrist | 15888 Main St, #112a, Hesperia, CA 92345-3452 | 2005-11-08 |
| 1164728788 | Hesperia Clinica Medica Familiar A Medical Corporation | Family Medicine | 15888 Main St, Suite 112b, Hesperia, CA 92345-3467 | 2011-01-28 |
| 1295065134 | Luis Andres Saldana | Chiropractor | 15888 Main St, Hesperia, CA 92345-3452 | 2009-12-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649881467 | Leslie Guzman | Behavioral Analyst | 6700 Newhall Ave, Hesperia, CA 92345 | 2020-08-14 |
| 1134769896 | Nu Wave Medical Group Inc | Family Medicine | 9390 Hesperia Rd Suite 7, Hesperia, CA 92345 | 2020-01-10 |
| 1760901383 | Lindsey Kathleen Dunnagan | Counselor | 16501 Walnut Street, Suite 12, Hesperia, CA 92345 | 2017-09-14 |
| 1356869374 | Deborah Irene Freeman | Nurse Practitioner | 15398 Main Street Suite A, Hesperia, CA 92345 | 2017-08-30 |
| 1902260151 | Serge Bronstein | Counselor | 16808 Main St., D-154, Hesperia, CA 92345 | 2016-04-13 |
| 1366815805 | Caremore Health Plan | Nurse Practitioner | 17085 Main Street, Hesperia, CA 92345 | 2015-11-05 |
| 1174928402 | Jennifer Cathrin Bayle | Counselor | 17130 Sequoia St, Suite 106, Hesperia, CA 92345 | 2014-10-29 |
| 1447654256 | Diana Grace Chilstrom | Marriage & Family Therapist | 11776 Mariposa Road, Hesperia, CA 92345 | 2014-10-22 |
| 1639597545 | Adrianna Ebony Williams | Physical Therapy Assistant | 8939 11th Ave, Hesperia, CA 92345 | 2014-03-29 |
| 1477974426 | Aja Stoll | Case Manager/Care Coordinator | 9655 Ninth Ave, Hesperia, CA 92345 | 2013-12-18 |
| Find all providers in zip 92345 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245644160 | One Stop Multi-specialty Medical Group & Therapy, Inc. | Non-Pharmacy Dispensing Site | 10918 Hesperia Rd, Suite B, Hesperia, CA 92345-2151 | 2014-06-18 |
| 1790004513 | One Stop Multi Specialty Medical Group, Inc | Non-Pharmacy Dispensing Site | 10918 Hesperia Rd Ste B, Hesperia, CA 92345-2151 | 2010-05-18 |
| 1750576344 | High Desert Primary Care | Non-Pharmacy Dispensing Site | 17095 Main St, Hesperia, CA 92345-6004 | 2007-09-07 |
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| 1023511045 | Performance Health Medical Group | Non-Pharmacy Dispensing Site | 25431 Cabot Road Suite 118, Laguna Hills, CA 92653 | 2018-03-15 |
| 1043719206 | Southern California Orthopedic Institute L.p | Non-Pharmacy Dispensing Site | 4100 Empire Dr Ste 120, Bakersfield, CA 93309-0408 | 2018-02-02 |
| 1174032353 | Golden Gate Urology, Inc. | Non-Pharmacy Dispensing Site | 139 Townsend St Ste 100, San Francisco, CA 94107-1946 | 2017-09-20 |
| 1215462080 | Mas Management Group, Inc. | Non-Pharmacy Dispensing Site | 28446 Constellation Rd, Valencia, CA 91355-5081 | 2017-04-28 |
| 1730624719 | St. John's Well Child and Family Center Inc | Non-Pharmacy Dispensing Site | 326 W 23rd St, Los Angeles, CA 90007-2612 | 2016-12-29 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.