Provider Demographics
NPI:1760465157
Name:HANFORD REGIONAL PHYSICIANS GROUP, INC
Entity type:Organization
Organization Name:HANFORD REGIONAL PHYSICIANS GROUP, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAJZOUBI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-583-4500
Mailing Address - Street 1:PO BOX 480
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93232-0480
Mailing Address - Country:US
Mailing Address - Phone:559-587-4349
Mailing Address - Fax:559-587-4345
Practice Address - Street 1:1524 W LACEY BLVD
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5965
Practice Address - Country:US
Practice Address - Phone:559-583-4500
Practice Address - Fax:559-583-4600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-21
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ27987ZMedicare PIN