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General NPI Number Information
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NPI Number | 1225796337
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Entity Type | Organization
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Legal Business Name | HANS-ON RECOVERY, PLLC
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Dates
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Enumeration Date | 12/06/2021
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 24552 PACIFIC PARK DR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3055
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Country | US
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Telephone | 518-413-1600
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Fax | 518-413-1600
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Provider Business Mailing Address
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Address Line | 1205 PACIFIC HWY UNIT 2202
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City | SAN DIEGO
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State | CA
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Zip | 92101-8464
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Country | US
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Telephone | 518-413-1600
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Fax | 518-413-1600
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Authorized Official
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Title or Position | OWNER
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Name | HANS CHRISTIAN GEISSE
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Credential | MD
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Telephone | 518-413-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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