Individual provider Active NPI

Andre Fouad Botros Hanna

  • Pharmacist
  • Irvine, CA
National Provider Identifier
1851777908
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
70774 Issued in CA
Practice address
196 Greenmoor
Irvine, CA 92614-7514
Phone
(714) 723-4748
NPI assigned
Jul 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 70774 CA Primary

Addresses

Primary practice location

196 Greenmoor
Irvine, CA 92614-7514

Mailing address

196 Greenmoor
Irvine, CA 92614-7514
Phone (714) 723-4748

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

State licenses

LicenseStateTypeSpecialty
70774CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Av Pharma Corp Current Accepting new patients
Av Pharma Corp Current Accepting new patients

Organizations & group practices 2

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": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438214400000",
    "number": "1851777908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 GREENMOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147514",
            "telephone_number": "714-723-4748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 GREENMOOR",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147514",
            "telephone_number": "714-723-4748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANNA",
        "first_name": "ANDRE",
        "middle_name": "FOUAD BOTROS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "70774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.