Individual provider Active NPI

Hanaa N Hanna, M.D.

  • Pediatrics Physician
  • San Pedro, CA
National Provider Identifier
1003954942
Registry record updated Apr 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A52577 Issued in CA
Practice address
887 W 9TH St
San Pedro, CA 90731-3603
Phone
(310) 547-0887
Fax
(310) 547-4296
NPI assigned
Feb 2, 2007
Last updated
Apr 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A38447 CA
Pediatrics Physician 208000000X A52577 CA Primary

Addresses

Primary practice location

887 W 9TH St
San Pedro, CA 90731-3603

Mailing address

887 W 9TH St
San Pedro, CA 90731-3603
Phone (310) 547-0887

Other identifiers 2

IdentifierTypeStateIssuer
1811342751OtherCANPPES
1952337321MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A52577CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Selem Care Pediatrics Current Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Torrance Memorial Medical Center Past Accepting new patients
Hanaa Hanna, MD., Inc. Pediatrics Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524441600000",
    "number": "1003954942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "887 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313603",
            "telephone_number": "310-547-0887",
            "fax_number": "310-547-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "887 W 9TH ST",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907313603",
            "telephone_number": "310-547-0887",
            "fax_number": "310-547-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "HANAA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2018-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A38447",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A52577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1811342751",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952337321",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Pedro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.