Healthcare Provider Details

I. General information

NPI: 1568393270
Provider Name (Legal Business Name): MR. PAUL FRANCIS AHERN JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 S BEAUDRY AVE
LOS ANGELES CA
90017-1466
US

IV. Provider business mailing address

4280 VIA ARBOLADA UNIT 205
LOS ANGELES CA
90042-5088
US

V. Phone/Fax

Practice location:
  • Phone: 213-241-1000
  • Fax:
Mailing address:
  • Phone: 626-922-0515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19673
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: