Individual provider Active NPI

Kambiz Hannani, MD

  • Orthopaedic Surgery of the Spine Physician
  • West Covina, CA
National Provider Identifier
1083782478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
A061933 Issued in CA
Practice address
1135 S Sunset Ave Ste 209
West Covina, CA 91790-3938
Phone
(626) 939-5900
Fax
(626) 939-0211
NPI assigned
Dec 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X A061933 CA Primary

Addresses

Primary practice location

1135 S Sunset Ave Ste 209
West Covina, CA 91790-3938

Mailing address

1135 S Sunset Ave Ste 209
West Covina, CA 91790-3938
Phone (626) 939-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080617000613 CA Practitioner - Orthopedic Surgery 4880765973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1135 S Sunset Ave
Suite 209
West Covina, CA 91790-3938

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A061933CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
K Hannani, MD Inc Orthopaedic Surgery of the Spine CurrentSince Jan 1, 2000 Accepting new patients

Locations

1135 S Sunset Ave
Ste 209
West Covina, CA 91790
Phone (626) 393-5900

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083782478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 209",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903938",
            "telephone_number": "626-939-5900",
            "fax_number": "626-939-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 S SUNSET AVE STE 209",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917903938",
            "telephone_number": "626-939-5900",
            "fax_number": "626-939-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNANI",
        "first_name": "KAMBIZ",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "A061933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

Verify at the official NPI Registry.