Individual
HANI S GHAWI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
350 E VANDERBILT WAY STE A, SAN BERNARDINO, CA 92408-3593
(909) 886-5200
(909) 382-9017
Mailing address
350 E VANDERBILT WAY STE A, SAN BERNARDINO, CA 92408-3593
(909) 886-5200
(909) 382-9017
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
036-125433
IL
2080P0202X
Pediatric Cardiology Physician
Primary
C164666
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002
—
LA
05
—
036125433
—
IL
Enumeration date
09/19/2007
Last updated
01/05/2021
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