Healthcare Provider Details

I. General information

NPI: 1194292193
Provider Name (Legal Business Name): JANET RHEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2018
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 HARBOR BLVD STE 3
COSTA MESA CA
92626-2514
US

IV. Provider business mailing address

6950 W DESERT INN RD STE 110
LAS VEGAS NV
89117-3171
US

V. Phone/Fax

Practice location:
  • Phone: 714-263-0227
  • Fax: 888-972-1912
Mailing address:
  • Phone: 702-259-5550
  • Fax: 702-259-5554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2132
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number56642
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: