Healthcare Provider Details

I. General information

NPI: 1467063826
Provider Name (Legal Business Name): HANNAH SHANNON RIHANI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 11/09/2020
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1737 MIDVALE AVE
LOS ANGELES CA
90024-5512
US

IV. Provider business mailing address

1737 MIDVALE AVE
LOS ANGELES CA
90024-5512
US

V. Phone/Fax

Practice location:
  • Phone: 310-254-7925
  • Fax:
Mailing address:
  • Phone: 310-254-7925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: