MEDICARE: KIANA HA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363A00000X	Physician Assistant
2	363AM0700X	Medical Physician Assistant
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1184560369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIANA HA

Provider Business Mailing Address
First Line	:	219 E AVENUE 31
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-2033
Country	:	US
Telephone Number	:	626-782-9009
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 E AVENUE 31
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90031-2033
Country	:	US
Telephone Number	:	626-782-9009
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/28/2026
Last Update Date	:	04/28/2026

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Directions to “ KIANA HA ” Practice Location

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