MEDICARE: PEDRO P HANI MD PC

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	7694	NV
2	207RP1001X	Pulmonary Disease Physician	7694	NV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7694	OTHER	NV	NV MEDICAL LICENSE

General Provider Information

NPI Number	:	1629397690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEDRO P HANI MD PC

Provider Business Mailing Address
First Line	:	8255 LAS VEGAS BLVD S
Second Line	:	UNIT 1719
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1064
Country	:	US
Telephone Number	:	469-544-7198
Fax Number	:

Provider Business Practice Location Address
First Line	:	8255 LAS VEGAS BLVD S
Second Line	:	UNIT 1719
City	:	LAS VEGAS
State	:	NV
Zip	:	89123-1064
Country	:	US
Telephone Number	:	469-544-7198
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PEDRO P HANI
Credential	:	MD
Telephone Number	:	469-544-7198

Provider Enumeration Date	:	05/28/2010
Last Update Date	:	05/28/2010

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Directions to “PEDRO P HANI MD PC ” Practice Location

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