MEDICARE: ZIYAD HANNON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	C40187	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00C401870	OTHER	CA	BLUE SHIELD OF CALIFORNIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1942206560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZIYAD HANNON M.D.

Provider Business Mailing Address
First Line	:	2645 OCEAN AVE
Second Line	:	STE 309
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2645 OCEAN AVE
Second Line	:	STE 309
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94132-1647
Country	:	US
Telephone Number	:	415-334-0999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	03/24/2008

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