Healthcare Provider Details

I. General information

NPI: 1487356531
Provider Name (Legal Business Name): HEALTH ACCESS FOR ALL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1049 W GARDENA BLVD
GARDENA CA
90247
US

IV. Provider business mailing address

PO BOX 57130
LOS ANGELES CA
90057
US

V. Phone/Fax

Practice location:
  • Phone: 866-981-3002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: PEYMAN BANOONI
Title or Position: CEO
Credential: MD
Phone: 310-625-4649