Provider Demographics
NPI:1285638619
Name:JANAI, HILLEL KINAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLEL
Middle Name:KINAN
Last Name:JANAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 BROAD ST
Mailing Address - Street 2:SUITE B 217
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-6786
Mailing Address - Country:US
Mailing Address - Phone:805-547-1255
Mailing Address - Fax:805-547-1395
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3898
Practice Address - Fax:805-614-5932
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2014-04-08
Deactivation Date:2006-04-03
Deactivation Code:
Reactivation Date:2006-04-19
Provider Licenses
StateLicense IDTaxonomies
CAA48584208000000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48584OtherMEDICAL LICENSE #
CAWA48584AMedicare PIN
CAWA48584EMedicare PIN
CAWA48584DMedicare PIN
CAWA48584FMedicare PIN
CADF913TMedicare PIN
CAA48584OtherMEDICAL LICENSE #
CAWA48584CMedicare PIN
CAWA48584BMedicare PIN