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NPI Code Detail

MEDICARE: ERIN HANAUER PA-C

MEDICARE:   ERIN  HANAUER  PA-C
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
1207RP1001XPulmonary Disease Physician004729GA
2363AM0700XMedical Physician AssistantPA21654CA
3363AM0700XMedical Physician Assistant004729GA

General Provider Information

NPI Number : 1851490718
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN HANAUER PA-C
Provider Business Mailing Address
First Line : 106 LYNCH CREEK WAY STE 8
Second Line : NORTH BAY DERMATOLOGY
City : PETALUMA
State : CA
Zip : 94954-2356
Country : US
Telephone Number : 707-763-6816
Fax Number : 707-763-1730
Provider Business Practice Location Address
First Line : 106 LYNCH CREEK WAY STE 8
Second Line : NORTH BAY DERMATOLOGY
City : PETALUMA
State : CA
Zip : 94954-2356
Country : US
Telephone Number : 707-763-6816
Fax Number : 707-763-1730
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 09/03/2019

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Directions to “ ERIN HANAUER PA-C” Practice Location

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