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Organization
I HENAWI MD INC
Active
Organization
I HENAWI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. I HENAWI M.D. (OWNER)
(951) 765-5000
Entity
Organization
Contact information
Practice address
4020 W FLORIDA AVE, HEMET, CA 92545-5279
(951) 765-5000
(951) 658-0237
Mailing address
4020 W FLORIDA AVE, HEMET, CA 92545-5279
(951) 765-5000
(951) 658-0237
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A62143
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144557539
—
CA
01
—
CS602A
PROVIDER NUMBER
CA
Enumeration date
11/06/2009
Last updated
06/11/2010
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