Eric R. Hansen, D.O., Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A8138 Issued in CA

Legal business name

ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION

Practice address

14575 Main St
Hesperia, CA 92345-3322

Phone

(760) 948-8470

Fax

(760) 947-6219

NPI assigned

Mar 27, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric R Hansen, D.O.NPI 1770562506

Title

C.E.O.

Phone

(760) 948-8470

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Eric R Hansen DO2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Eric R. Hansen, D.O., Professional Corporation

  dba Eric R. Hansen, DO

  • Non-Pharmacy Dispensing Site
  • Hesperia, CA
  • NPI 1801937479
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Rodney Hansen, D.O.

  • Family Medicine Physician
  • Hesperia, CA
  • NPI 1770562506
  Medicare reassignment NPD Authorized official
• Quyen T Despas, PA-C

  • Physician Assistant
  • Hesperia, CA
  • NPI 1154454908
  NPD (past)
• Jennifer L Eastman, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • San Diego, CA
  • NPI 1962854034
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443052800000",
    "number": "1912025958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14575 MAIN ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923453322",
            "telephone_number": "760-948-8470",
            "fax_number": "760-947-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14575 MAIN ST",
            "city": "HESPERIA",
            "state": "CA",
            "postal_code": "923453322",
            "telephone_number": "760-948-8470",
            "fax_number": "760-947-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC R. HANSEN, D.O., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2015-09-24",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "760-948-8470",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC1926",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX81380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jose Enciso Jr.
• Cynthia Enriquez
• Kimberly Epps
• Eric J Storm & Brenda J Reid
• Eric R. Hansen, D.O., Professional Corporation (Eric R. Hansen, DO)
• Lajoi Ervin, LVN
• Amanda Ann Escarzaga, SLPA
• Jocelyn Esparza
• Juliana Esparza
• Juliana Espinosa

• Family Medicine Physician in Hesperia, CA
• Providers in Hesperia, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.