| Carlson, Hansen, Kwon-hong, Mds | |
|
1213 Coffee Rd Suite A Modesto CA 95355-4229 | |
| (209) 549-9900 | |
| Not Available |
| Full Name | Carlson, Hansen, Kwon-hong, Mds |
|---|---|
| Speciality | Family Medicine |
| Location | 1213 Coffee Rd, Modesto, California |
| Authorized Official Name and Position | James M Carlson (MANAGING PARTNER) |
| Authorized Official Contact | 2095499900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Carlson, Hansen, Kwon-hong, Mds 5101 Mesa Dr Oakdale CA 95361-7858 Ph: (209) 848-8903 | Carlson, Hansen, Kwon-hong, Mds 1213 Coffee Rd Suite A Modesto CA 95355-4229 Ph: (209) 549-9900 |
| NPI Number | 1568543783 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568543783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G27090 (California) | Primary |
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