Healthcare Provider Details

I. General information

NPI: 1205329000
Provider Name (Legal Business Name): DANIELLE MEKAHEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 N CAMDEN DR STE 1130
BEVERLY HILLS CA
90210-4415
US

IV. Provider business mailing address

433 N CAMDEN DR STE 1130
BEVERLY HILLS CA
90210-4415
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-5052
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: