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General NPI Number Information
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NPI Number | 1417421850
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Entity Type | Organization
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Legal Business Name | HEALTH ACCESS FOR ALL INC
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Dates
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Enumeration Date | 01/18/2019
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Last Update Date | 01/18/2019
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Provider Practice Location Address
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Address Line | 1030 GARDENA BLVD
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City | GARDENA
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State | CA
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Zip | 90247-4956
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Country | US
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Telephone | 424-222-8800
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Fax | 424-222-8999
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Provider Business Mailing Address
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Address Line | P.O. BOX 57130
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City | LOS ANGELES
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State | CA
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Zip | 90212-3851
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Country | US
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Telephone | 213-413-2222
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Fax | 213-483-1711
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Authorized Official
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Title or Position | CEO
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Name | MR. PEYMAN BANOONI
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Credential | M.D.
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Telephone | 310-625-4649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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