Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Chad Russell Hansen, IDC

Individual provider Independent Duty Corpsman · NPI 1588941660

Chad Russell Hansen, IDC is an Independent Duty Corpsman in San Diego, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2011
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Practice location Address checks out

34101 Farenholt Ave
San Diego, CA 92134-7000
Phone: (520) 289-6568
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Independent Duty Corpsman (primary) Taxonomy 1710I1002X (CA)

Record details

NPI number1588941660
Entity typeIndividual (Type 1)
GenderMale
Credentials IDC
Sole proprietorYes
NPI enumeratedNovember 3, 2011
Last updated in NPPESNovember 3, 2011

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