Provider Demographics
NPI:1376697151
Name:ZAKI, HANY KAMEL (MD)
Entity Type:Individual
Prefix:DR
First Name:HANY
Middle Name:KAMEL
Last Name:ZAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HANY
Other - Middle Name:KAMEL
Other - Last Name:ZAKI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
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
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA53393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A533931Medicaid
CAA53393OtherSTATE LIC #
CAP00092524OtherMEDICAR RAILROAD PIN
CADB2070OtherMEDICARE RAILROAD GROUP #
CAA53393OtherSTATE LIC #
CA00A533931Medicaid