Healthcare Provider Details

I. General information

NPI: 1235093733
Provider Name (Legal Business Name): HANNAHEALTH GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3322 SWEETWATER SPRINGS BLVD STE 106
SPRING VALLEY CA
91977-3142
US

IV. Provider business mailing address

3322 SWEETWATER SPRINGS BLVD STE 106
SPRING VALLEY CA
91977-3142
US

V. Phone/Fax

Practice location:
  • Phone: 619-930-9490
  • Fax: 619-741-0017
Mailing address:
  • Phone: 619-930-9490
  • Fax: 619-741-0017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TOM ELIAS HANNA
Title or Position: CEO
Credential: ESQ.
Phone: 619-930-9490