Healthcare Provider Details

I. General information

NPI: 1043993504
Provider Name (Legal Business Name): SARA HARIRI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2023
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2841 LOMITA BLVD STE 100
TORRANCE CA
90505-5100
US

IV. Provider business mailing address

2841 LOMITA BLVD STE 100
TORRANCE CA
90505-5100
US

V. Phone/Fax

Practice location:
  • Phone: 310-257-0508
  • Fax:
Mailing address:
  • Phone: 949-573-3411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number67488
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: