MEDICARE: MR. MARLAND ABE HANSEN 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
1	207Q00000X	Family Medicine Physician	G13797	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568469138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARLAND ABE HANSEN MD

Provider Business Mailing Address
First Line	:	2068 TALBERT DR
Second Line	:	STE 150
City	:	CHICO
State	:	CA
Zip	:	95928-7723
Country	:	US
Telephone Number	:	530-809-0009
Fax Number	:	530-809-0399

Provider Business Practice Location Address
First Line	:	812 E D ST
Second Line	:
City	:	LEMOORE
State	:	CA
Zip	:	93245-9545
Country	:	US
Telephone Number	:	559-925-1000
Fax Number	:	559-925-1084

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	12/08/2016

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