MEDICARE: HANNA HEALTH CLINIC

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
1	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1497416416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANNA HEALTH CLINIC

Provider Business Mailing Address
First Line	:	2017 PINTO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4018
Country	:	US
Telephone Number	:	702-542-5868
Fax Number	:	725-251-2461

Provider Business Practice Location Address
First Line	:	2017 PINTO LN
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4018
Country	:	US
Telephone Number	:	702-542-5868
Fax Number	:	725-251-2461

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ROXANA NAOMI TEJADA JITSUYA
Credential	:	M.D
Telephone Number	:	702-542-5868

Provider Enumeration Date	:	01/03/2022
Last Update Date	:	01/03/2022

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Directions to “HANNA HEALTH CLINIC ” Practice Location

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