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General NPI Number Information
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NPI Number | 1073835617
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Entity Type | Individual
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Provider Name | JEAN MARIE HANLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2010
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 1131 N PACIFIC AVE
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City | GLENDALE
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State | CA
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Zip | 91202-2358
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Country | US
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Telephone | 818-639-8780
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Fax | 888-981-7934
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Provider Business Mailing Address
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Address Line | 425 15TH ST UNIT 3071
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City | MANHATTAN BEACH
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State | CA
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Zip | 90266-7305
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Country | US
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Telephone | 310-413-4140
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Fax | 888-981-7934
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | G072969
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License Number State | CA
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