Healthcare Provider Details

I. General information

NPI: 1083297907
Provider Name (Legal Business Name): LANA HARIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39000 BOB HOPE DR AHSB SUITE 201
RANCHO MIRAGE CA
92270
US

IV. Provider business mailing address

39000 BOB HOPE DRIVE AHSB SUITE 201
RANCHO MIRAGE CA
92270
US

V. Phone/Fax

Practice location:
  • Phone: 760-773-2968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA195145
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number76322
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: