Healthcare Provider Details

I. General information

NPI: 1417874058
Provider Name (Legal Business Name): DANE RANA, DO, A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 N AZUSA AVE
COVINA CA
91722-3502
US

IV. Provider business mailing address

525 N AZUSA AVE
COVINA CA
91722-3502
US

V. Phone/Fax

Practice location:
  • Phone: 702-250-9374
  • Fax:
Mailing address:
  • Phone: 702-250-9374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DANE RANA
Title or Position: PRESIDENT
Credential: DO
Phone: 702-250-9374