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General NPI Number Information
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NPI Number | 1639286263
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Entity Type | Individual
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Provider Name | FATMA HANEY M.D
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Gender | Female
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 840 WINTHROP RD
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City | SAN MARINO
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State | CA
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Zip | 91108-1708
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Country | US
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Telephone | 575-622-2606
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Fax | 575-622-6645
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Provider Business Mailing Address
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Address Line | 840 WINTHROP RD
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City | SAN MARINO
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State | CA
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Zip | 91108-1708
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Country | US
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Telephone | 575-622-2606
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Fax | 575-622-6645
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | MD2006-0086
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | A063529
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License Number State | CA
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