Organization Active NPI

Hana Holistic Medical Center

  • Internal Medicine Physician
  • Berkeley, CA
National Provider Identifier
1588054076
Registry record updated Oct 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
73394 Issued in CA
Legal business name
HANA HOLISTIC MEDICAL CENTER
Practice address
2107 Channing Way
Berkeley, CA 94704-2020
Phone
(510) 527-1678
Fax
(510) 527-1848
NPI assigned
Feb 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2015

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

Authorized official

Name
Anas Hana, MDNPI 1811076557
Title
President
Phone
(510) 527-1678

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 73394 CA Primary

Addresses

Primary practice location

2107 Channing Way
Berkeley, CA 94704-2020

Mailing address

2107 Channing Way
Berkeley, CA 94704-2020
Phone (510) 527-1678

Other identifiers 1

IdentifierTypeStateIssuer
CA161667OtherCAPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150811005497 CA Part B Supplier - Clinic/Group Practice 1355656968 Receives reassigned benefits from 1 practitioner
Practice locations: Berkeley, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2107195Hana Holistic Medical Center2107 Channing Way, Berkeley, CA 94704Provider-performed microscopyJan 6, 2028

National Provider Directory

National Provider Directory

Locations

2107 Channing Way
Berkeley, CA 94704
Phone (510) 527-1678

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445299200000",
    "number": "1588054076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 CHANNING WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042020",
            "telephone_number": "510-527-1678",
            "fax_number": "510-527-1848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 CHANNING WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947042020",
            "telephone_number": "510-527-1678",
            "fax_number": "510-527-1848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANA HOLISTIC MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-04",
        "last_updated": "2015-10-20",
        "status": "A",
        "authorized_official_last_name": "HANA",
        "authorized_official_first_name": "ANAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-527-1678",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "73394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "CA161667",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; 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.

Verify at the official NPI Registry.