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NPI Code Detail

MEDICARE: DR. LAUREN ELYSE HANLEY MD

MEDICARE:  DR. LAUREN ELYSE HANLEY  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician205446MA
2207V00000XObstetrics & Gynecology PhysicianC174771CA

General Provider Information

NPI Number : 1053392035
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LAUREN ELYSE HANLEY MD
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number :
Provider Business Practice Location Address
First Line : 1809 NATIONAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92113-2113
Country : US
Telephone Number : 619-515-2300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 04/04/2022

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Directions to “ DR. LAUREN ELYSE HANLEY MD” Practice Location

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