Basic Information
| Provider Information | |||||||||
| NPI: | 1942523642 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EL JAMMAL | ||||||||
| FirstName: | HANI | ||||||||
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| OtherLastName: | EL JAMMAL | ||||||||
| OtherFirstName: | HANI | ||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 12900 PARK PLAZA DR STE 150 | ||||||||
| Address2: | |||||||||
| City: | CERRITOS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 907039329 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262228005 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1182 N EUCLID ST | ||||||||
| Address2: | |||||||||
| City: | ANAHEIM | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143999222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/09/2010 | ||||||||
| LastUpdateDate: | 08/30/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A11034 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.