Provider Demographics
NPI:1497416416
Name:HANNA HEALTH CLINIC
Entity Type:Organization
Organization Name:HANNA HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROXANA
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:TEJADA JITSUYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:702-542-5868
Mailing Address - Street 1:2017 PINTO LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4018
Mailing Address - Country:US
Mailing Address - Phone:702-542-5868
Mailing Address - Fax:725-251-2461
Practice Address - Street 1:2017 PINTO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4018
Practice Address - Country:US
Practice Address - Phone:702-542-5868
Practice Address - Fax:725-251-2461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-03
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty