Active NPI
I Henawi MD Inc
- General Practice Physician
- Hemet, CA
National Provider Identifier
1144557539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A62143
- Legal business name
- I HENAWI MD INC
- Practice address
- 4020 W Florida Ave
Hemet, CA 92545-5279 - Phone
- (951) 765-5000
- Fax
- (951) 658-0237
- NPI assigned
- Nov 6, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. I Henawi, M.D.
- Title
- Owner
- Phone
- (951) 765-5000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A62143 | CA | Primary |
Addresses
Primary practice location
4020 W Florida Ave
Hemet, CA 92545-5279
Mailing address
4020 W Florida Ave
Hemet, CA 92545-5279
Phone (951) 765-5000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144557539 | Medicaid | CA | |
| CS602A | Other | CA | PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2002896 | I Henawi, MD Inc | Certificate of waiver | Jan 27, 2028 |
National Provider Directory
National Provider DirectoryLocations
4020 W Florida Ave
Ste 8
Hemet, CA 92545
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Physician
- Hemet, CA
- NPI 1023234812
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1257465600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1276214400000",
"number": "1144557539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4020 W FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925455279",
"telephone_number": "951-765-5000",
"fax_number": "951-658-0237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4020 W FLORIDA AVE",
"city": "HEMET",
"state": "CA",
"postal_code": "925455279",
"telephone_number": "951-765-5000",
"fax_number": "951-658-0237"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "I HENAWI MD INC",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-06",
"last_updated": "2010-06-11",
"status": "A",
"authorized_official_last_name": "HENAWI",
"authorized_official_first_name": "I",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "951-765-5000",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "General Practice",
"state": "CA",
"license": "A62143",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1144557539",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER NUMBER",
"identifier": "CS602A",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hemet, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.