Provider Demographics
NPI:1770663502
Name:HANKINS, E. A III (MD)
Entity Type:Individual
Prefix:DR
First Name:E.
Middle Name:A
Last Name:HANKINS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BILLY
Other - Middle Name:
Other - Last Name:HANKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:9526 LA TUNA CANYON RD
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-2230
Mailing Address - Country:US
Mailing Address - Phone:818-767-5457
Mailing Address - Fax:323-783-4646
Practice Address - Street 1:1515 N VERMONT AVE SOCA PERM MED GROUP
Practice Address - Street 2:5TH FLOOR DERMATOLOGY
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:323-783-4162
Practice Address - Fax:323-783-4646
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG11159207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology