Healthcare Provider Details

I. General information

NPI: 1093304313
Provider Name (Legal Business Name): HANNA PAIN RELIEF CLINICS PMC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/12/2021
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1723 27TH ST
BAKERSFIELD CA
93301-2807
US

IV. Provider business mailing address

PO BOX 6470
ANAHEIM CA
92816-6470
US

V. Phone/Fax

Practice location:
  • Phone: 310-499-3594
  • Fax: 855-678-4600
Mailing address:
  • Phone: 310-499-3594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNY E HANNA JR.
Title or Position: AUTHORIZED OFFICIAL/OWNER
Credential: MD
Phone: 310-499-3594