Active NPI
Paul Robert Hansen, PHARM.D.
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Vallejo, CA
National Provider Identifier
1194034710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- 63493
- Practice address
- 1310 Johnson Lane
Mare Island
Vallejo, CA 94592 - Phone
- (804) 754-6118
- NPI assigned
- Sep 30, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 63493 | CA | Primary |
Addresses
Primary practice location
1310 Johnson Lane
Mare Island
Vallejo, CA 94592
Mailing address
6576 Friars Rd
Apt. 105
San Diego, CA 92108-1000
Phone (804) 754-6118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63493 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1194034710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6576 FRIARS RD",
"address_2": "APT. 105",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921081000",
"telephone_number": "804-754-6118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 JOHNSON LANE",
"address_2": "MARE ISLAND",
"city": "VALLEJO",
"state": "CA",
"postal_code": "94592",
"telephone_number": "804-754-6118"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "PAUL",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-30",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "CA",
"license": "63493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.