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General NPI Number Information
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NPI Number | 1215617642
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Entity Type | Individual
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Provider Name | MIKAEH TRAHAN M.A.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2023
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 3537 JOHNSON AVE
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City | EL MONTE
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State | CA
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Zip | 91731-3211
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Country | US
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Telephone | 626-444-9005
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Fax |
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Provider Business Mailing Address
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Address Line | 26836 CALLE VEJAR
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City | MORENO VALLEY
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State | CA
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Zip | 92555-4117
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Country | US
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Telephone | 951-956-0708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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