| Ibrahim Hanna, M.d., Inc. | |
|
640 W. Foothill Blvd. Suite 100 Glendora CA 91741-2403 | |
| (626) 335-4041 | |
| (626) 335-3768 |
| Full Name | Ibrahim Hanna, M.d., Inc. |
|---|---|
| Speciality | Internal Medicine |
| Location | 640 W. Foothill Blvd., Glendora, California |
| Authorized Official Name and Position | Patricia Hanna (OFFICE MANAGER) |
| Authorized Official Contact | 6263354041 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ibrahim Hanna, M.d., Inc. 640 W. Foothill Blvd. Suite 100 Glendora CA 91741-2403 Ph: (626) 335-4041 | Ibrahim Hanna, M.d., Inc. 640 W. Foothill Blvd. Suite 100 Glendora CA 91741-2403 Ph: (626) 335-4041 |
| NPI Number | 1922316751 |
|---|---|
| Provider Enumeration Date | 09/14/2010 |
| Last Update Date | 01/20/2012 |
| Medicare PECOS PAC ID | 2769669662 |
|---|---|
| Medicare Enrollment ID | O20110601000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922316751 | NPI | - | NPPES |
| 110238745 | Other | CA | RAILROAD MEDICARE |
| 00A502591 | Medicaid | CA | |
| DR4687 | Other | CA | MEDICARE RR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A50259 (California) | Primary |
| Provider Name | Ibrahim Issa Hanna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407898653 PECOS PAC ID: 5597892638 Enrollment ID: I20100422000257 |
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