Provider Demographics
NPI:1033307061
Name:HANY K. ZAKI,M.D,INC
Entity Type:Organization
Organization Name:HANY K. ZAKI,M.D,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:DE LOS SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-564-9758
Mailing Address - Street 1:150 N HILL AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-1907
Mailing Address - Country:US
Mailing Address - Phone:626-564-9758
Mailing Address - Fax:626-564-9104
Practice Address - Street 1:150 N HILL AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-1907
Practice Address - Country:US
Practice Address - Phone:626-564-9758
Practice Address - Fax:626-564-9104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A533931Medicaid
CAA53393OtherSTATE LIC#
CADB2070OtherMEDICARE RAELROAD GROUP#
CAP00092524OtherMEDICARE RAILROAD PIN NUM
CAP00092524OtherMEDICARE RAILROAD PIN NUM
CAG02986Medicare UPIN