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General NPI Number Information
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NPI Number | 1326112913
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Entity Type | Individual
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Provider Name | SAMEH R HANNA M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 401 E HIGHLAND AVE STE 251
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-3800
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Country | US
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Telephone | 909-864-4700
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Fax | 909-383-4009
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Provider Business Mailing Address
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Address Line | 3400 DATA DR ATTENTION: CREDENTIALING AND PAYER ENROLLMENT DEPT
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | C168064
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 168064
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License Number State | CA
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