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Individual

DR. TARA HANJAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
35800 BOB HOPE DR, SUITE 150A, RANCHO MIRAGE, CA 92270-1739
(760) 770-1920
(760) 324-0848
Mailing address
35800 BOB HOPE DR, SUITE 150A, RANCHO MIRAGE, CA 92270-1739
(760) 770-1920
(760) 324-0848

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
227925-1
NY
2085R0204X
Vascular & Interventional Radiology Physician
Primary
227925-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02186203
MEDICAID GROUP #
NY
05
2572521
NY
01
8691908
MEDICAID GROUP#
NY
01
W34991
MEDICARE GROUP#
NY
01
W35021
MEDICARE GROUP #
NY
Enumeration date
06/18/2006
Last updated
02/01/2017
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