Healthcare Provider Details

I. General information

NPI: 1174937346
Provider Name (Legal Business Name): DHUHA ALHANKAWI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 06/14/2021
Certification Date: 06/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8860 CENTER DR STE 330
LA MESA CA
91942-7001
US

IV. Provider business mailing address

8860 CENTER DR STE 330
LA MESA CA
91942-7001
US

V. Phone/Fax

Practice location:
  • Phone: 619-460-4055
  • Fax: 619-460-5148
Mailing address:
  • Phone: 619-460-4055
  • Fax: 619-460-5148

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberA152114
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA152114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: