Individual provider Active NPI

Iman Nabil Hanna, MD

  • Psychiatry Physician
  • Upland, CA
National Provider Identifier
1831247766
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
A55259 Issued in CA
Practice address
585N Mountain Ave B
Upland, CA 91786-8516
Phone
(909) 931-3388
Fax
(909) 931-7311
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X A55259 CA Primary

Addresses

Primary practice location

585N Mountain Ave B
Upland, CA 91786-8516

Mailing address

585N Mountain Ave B
Upland, CA 91786-8516
Phone (909) 931-3388

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
I20140109000563 CA Practitioner - Psychiatry 2567523319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Mountain View Behavioral Health IncGroup PAC ID 4385725266, 5 clinicians

Practice addresses (Care Compare)

585 N Mountain Ave
Suite B
Upland, CA 91786-8516
Phone (909) 931-3388

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55259CAMDDentist
A55259CAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Behavioral Health,Inc. CurrentSince Jan 1, 2014 Accepting new patients
Pacific Clinics Past Accepting new patients
Ashleywilliams Counseling, Inc Past Accepting new patients

Locations

12602 Central Ave
Chino, CA 91710

585 N Mountain Ave
Ste B
Upland, CA 91786
Phone (909) 702-2068

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440115200000",
    "number": "1831247766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585N MOUNTAIN AVE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-931-3388",
            "fax_number": "909-931-7311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585N MOUNTAIN AVE B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917868516",
            "telephone_number": "909-931-3388",
            "fax_number": "909-931-7311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "IMAN",
        "middle_name": "NABIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2015-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A55259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

Verify at the official NPI Registry.