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General NPI Number Information
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NPI Number | 1063520526
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Entity Type | Individual
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Provider Name | RONALD HANSEL MAIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/26/2006
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 2604B EL CAMINO REAL STE 275
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City | CARLSBAD
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State | CA
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Zip | 92008-1214
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Country | US
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Telephone | 442-888-4176
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Fax |
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Provider Business Mailing Address
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Address Line | 2604B EL CAMINO REAL STE 275
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City | CARLSBAD
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State | CA
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Zip | 92008-1214
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Country | US
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Telephone | 442-888-4176
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 01094694A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G40882
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License Number State | CA
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