Provider Demographics
NPI:1134154628
Name:FRANCINE HANBERG, M.D.
Entity type:Organization
Organization Name:FRANCINE HANBERG, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANCINE
Authorized Official - Middle Name:BRYANNE
Authorized Official - Last Name:HANBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-843-1819
Mailing Address - Street 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE G
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-843-1819
Mailing Address - Fax:818-843-1964
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE G
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-843-1819
Practice Address - Fax:818-843-1964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2015-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ09741ZOtherGROUP PROVIDER NUMBER
CAGR0093270Medicaid
CAGR0093270Medicaid