| I Henawi Md Inc | |
|
4020 W Florida Ave Hemet CA 92545-5279 | |
| (951) 765-5000 | |
| (951) 658-0237 |
| Full Name | I Henawi Md Inc |
|---|---|
| Speciality | General Practice |
| Location | 4020 W Florida Ave, Hemet, California |
| Authorized Official Name and Position | I Henawi (OWNER) |
| Authorized Official Contact | 9517655000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I Henawi Md Inc 4020 W Florida Ave Hemet CA 92545-5279 Ph: (951) 765-5000 | I Henawi Md Inc 4020 W Florida Ave Hemet CA 92545-5279 Ph: (951) 765-5000 |
| NPI Number | 1144557539 |
|---|---|
| Provider Enumeration Date | 11/06/2009 |
| Last Update Date | 06/11/2010 |
| Medicare PECOS PAC ID | 4789727090 |
|---|---|
| Medicare Enrollment ID | O20100209000618 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144557539 | NPI | - | NPPES |
| 1144557539 | Medicaid | CA | |
| CS602A | Other | CA | PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A62143 (California) | Primary |
| Provider Name | Iglal El Henawi |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1023234812 PECOS PAC ID: 5890838106 Enrollment ID: I20100209000604 |
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