Provider Demographics
NPI:1801982632
Name:RANA, HUMERA (MD)
Entity type:Individual
Prefix:DR
First Name:HUMERA
Middle Name:
Last Name:RANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11705 SLATE AVE
Mailing Address - Street 2:#200
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92505
Mailing Address - Country:US
Mailing Address - Phone:601-249-0013
Mailing Address - Fax:601-249-0592
Practice Address - Street 1:11705 SLATE AVE
Practice Address - Street 2:#200
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505
Practice Address - Country:US
Practice Address - Phone:800-274-3893
Practice Address - Fax:951-359-1999
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19447207R00000X
CAA113489207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine