Basic Information
| Provider Information | |||||||||
| NPI: | 1285638619 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JANAI | ||||||||
| FirstName: | HILLEL | ||||||||
| MiddleName: | KINAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3000 BROAD ST | ||||||||
| Address2: | SUITE B 217 | ||||||||
| City: | SAN LUIS OBISPO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934016786 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8055471255 | ||||||||
| FaxNumber: | 8055471395 | ||||||||
| Practice Location | |||||||||
| Address1: | 1400 E CHURCH ST | ||||||||
| Address2: | |||||||||
| City: | SANTA MARIA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 934545906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8057393898 | ||||||||
| FaxNumber: | 8056145932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2005 | ||||||||
| LastUpdateDate: | 04/08/2014 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 04/03/2006 | ||||||||
| NPIReactivationDate: | 04/19/2006 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | A48584 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | 208M00000X | A48584 | CA | N | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | A48584 | 01 | CA | MEDICAL LICENSE # | OTHER |