Healthcare Provider Details

I. General information

NPI: 1497742852
Provider Name (Legal Business Name): JAMES HOBART HANSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 52ND ST
OAKLAND CA
94609-1809
US

IV. Provider business mailing address

830 TRESTLE GLEN RD
OAKLAND CA
94610-2318
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3719
  • Fax: 510-450-5885
Mailing address:
  • Phone: 510-428-3719
  • Fax: 510-450-5885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberG53697
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: