Provider Demographics
NPI:1538312871
Name:HANAFY, ASHRAF (LMT)
Entity Type:Individual
Prefix:
First Name:ASHRAF
Middle Name:
Last Name:HANAFY
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 E BLITHEDALE AVE STE D
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:203 E BLITHEDALE AVE STE D
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2000
Practice Address - Country:US
Practice Address - Phone:415-381-1035
Practice Address - Fax:415-381-1160
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-30
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9100010837173C00000X
CA004339225700000X
CA000464225700000X
CA00789225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA116826Other116826