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NPI Code Detail

MEDICARE: SANDY HANNA

MEDICARE: SANDY HANNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist74500CA

General Provider Information

NPI Number : 1154831873
Entity Type Code : Individual
Provider Name (Legal Business Name) : SANDY HANNA
Provider Business Mailing Address
First Line : PO BOX 8507
Second Line :
City : FOUNTAIN VALLEY
State : CA
Zip : 92728-8507
Country : US
Telephone Number : 619-761-4937
Fax Number :
Provider Business Practice Location Address
First Line : 6301 BEACH BLVD STE 105
Second Line :
City : BUENA PARK
State : CA
Zip : 90621-4039
Country : US
Telephone Number : 714-690-0349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2017
Last Update Date : 03/17/2018

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