Provider Demographics
NPI:1831106178
Name:HANSEN, CHRISTIAN LLOYD (MD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LLOYD
Last Name:HANSEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX HH
Mailing Address - Street 2:BUSINESS DEVELOPMENT & CONTRACTING
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93942
Mailing Address - Country:US
Mailing Address - Phone:831-622-2716
Mailing Address - Fax:
Practice Address - Street 1:23625 HOLMAN HWY
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5902
Practice Address - Country:US
Practice Address - Phone:831-624-5311
Practice Address - Fax:831-625-4948
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55801207ZH0000X, 207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA220028028OtherRAILROAD
CA00A558010Medicare ID - Type Unspecified
CAG95321Medicare UPIN