MEDICARE: REIHANEH D NOVEIR PA-C

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA62447	CA

General Provider Information

NPI Number	:	1427755297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REIHANEH D NOVEIR PA-C

Provider Business Mailing Address
First Line	:	5339 LINDLEY AVE UNIT 302
Second Line	:
City	:	TARZANA
State	:	CA
Zip	:	91356-3719
Country	:	US
Telephone Number	:	310-980-2787
Fax Number	:

Provider Business Practice Location Address
First Line	:	640 S SAN VICENTE BLVD STE 220
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-4884
Country	:	US
Telephone Number	:	323-642-6455
Fax Number	:

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

Provider Enumeration Date	:	02/13/2023
Last Update Date	:	11/07/2025

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