Provider Demographics
NPI:1619942034
Name:HANONO, HELFON (O D)
Entity Type:Individual
Prefix:DR
First Name:HELFON
Middle Name:
Last Name:HANONO
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:894 PALM AVE
Mailing Address - Street 2:STE. B
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-1573
Mailing Address - Country:US
Mailing Address - Phone:619-424-9333
Mailing Address - Fax:
Practice Address - Street 1:894 PALM AVE
Practice Address - Street 2:STE. B
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-1573
Practice Address - Country:US
Practice Address - Phone:619-424-9333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-20
Last Update Date:2022-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6681-TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0066812Medicaid
CASD0066812Medicaid
CAOP6681BMedicare ID - Type Unspecified