Healthcare Provider Details

I. General information

NPI: 1457215915
Provider Name (Legal Business Name): MS. YAEL MEHRANNIA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 N LA CIENEGA BLVD STE 107
BEVERLY HILLS CA
90211-2283
US

IV. Provider business mailing address

PO BOX 351664
LOS ANGELES CA
90035-8807
US

V. Phone/Fax

Practice location:
  • Phone: 310-652-5292
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number67901
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: