Provider Demographics
NPI:1063476448
Name:HANSCOM, THOMAS ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALAN
Last Name:HANSCOM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2021 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE # 720E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2208
Mailing Address - Country:US
Mailing Address - Phone:310-829-3303
Mailing Address - Fax:310-829-3301
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:SUITE # 720E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2208
Practice Address - Country:US
Practice Address - Phone:310-829-3303
Practice Address - Fax:310-829-3301
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2014-05-28
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Provider Licenses
StateLicense IDTaxonomies
CAG34319207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology