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General NPI Number Information
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NPI Number | 1134635667
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Entity Type | Organization
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Legal Business Name | SELEM CARE
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 2700 N BELLFLOWER BLVD STE 201
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City | LONG BEACH
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State | CA
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Zip | 90815-1144
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Country | US
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Telephone | 562-938-9711
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Fax | 562-938-9711
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Provider Business Mailing Address
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Address Line | 2700 N BELLFLOWER BLVD STE 201
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City | LONG BEACH
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State | CA
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Zip | 90815-1144
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Country | US
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Telephone | 562-938-9711
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Fax | 562-938-9701
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Authorized Official
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Title or Position | OWNER
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Name | DR. HANAA HANNA
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Credential | MD
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Telephone | 562-938-9711
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A52577
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License Number State | CA
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