Provider Demographics
NPI:1124534904
Name:HANNA, RANIA BOTROS
Entity type:Individual
Prefix:
First Name:RANIA
Middle Name:BOTROS
Last Name:HANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5344 LOS MONTEROS
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-5107
Mailing Address - Country:US
Mailing Address - Phone:714-380-0504
Mailing Address - Fax:
Practice Address - Street 1:5344 LOS MONTEROS
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-5107
Practice Address - Country:US
Practice Address - Phone:714-380-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-16
Last Update Date:2017-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95008177207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine