Healthcare Provider Details

I. General information

NPI: 1114774130
Provider Name (Legal Business Name): HANNAH SON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2024
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

363 S MAIN ST STE 485
ORANGE CA
92868-3813
US

IV. Provider business mailing address

8135 PAINTER AVE STE 103
WHITTIER CA
90602-3171
US

V. Phone/Fax

Practice location:
  • Phone: 714-835-4800
  • Fax: 714-835-1900
Mailing address:
  • Phone: 562-698-6888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA64416
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: