MEDICARE: SINDALISA HEAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207RI0200X	Infectious Disease Physician	A137717	CA

General Provider Information

NPI Number	:	1235559436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SINDALISA HEAN

Provider Business Mailing Address
First Line	:	1000 W CARSON ST
Second Line	:	BOX 400
City	:	TORRANCE
State	:	CA
Zip	:	90502-2004
Country	:	US
Telephone Number	:	310-222-2401
Fax Number	:

Provider Business Practice Location Address
First Line	:	1043 ELM AVE STE 301
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-3295
Country	:	US
Telephone Number	:	562-624-4943
Fax Number	:	562-624-4974

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2014
Last Update Date	:	06/05/2019

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Directions to “ SINDALISA HEAN ” Practice Location

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