Provider Demographics
NPI:1114984366
Name:HANBERG, FRANCINE BRYANNE (MD)
Entity Type:Individual
Prefix:MS
First Name:FRANCINE
Middle Name:BRYANNE
Last Name:HANBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-843-1819
Mailing Address - Fax:818-843-1964
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-843-1819
Practice Address - Fax:818-843-1964
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-28
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG53850207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G538500Medicaid
CA00G538500Medicaid
F48645Medicare UPIN