Provider Demographics
NPI:1598826661
Name:IRANI, HILLA P (MD)
Entity Type:Individual
Prefix:
First Name:HILLA
Middle Name:P
Last Name:IRANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5730 PACKARD AVE
Mailing Address - Street 2:STE 600
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-7118
Mailing Address - Country:US
Mailing Address - Phone:530-741-6264
Mailing Address - Fax:530-741-9274
Practice Address - Street 1:5730 PACKARD AVE
Practice Address - Street 2:STE 600
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-7118
Practice Address - Country:US
Practice Address - Phone:530-741-6245
Practice Address - Fax:530-741-9274
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2013-09-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA029714207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A297140Medicare ID - Type Unspecified
A25857Medicare UPIN