MEDICARE: YASSAMAN MAY SOBHANI MS PA

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	363AM0700X	Medical Physician Assistant	PA15767	CA

General Provider Information

NPI Number	:	1487726634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YASSAMAN MAY SOBHANI MS PA

Provider Business Mailing Address
First Line	:	P.O. BOX 49379
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049
Country	:	US
Telephone Number	:	310-770-2762
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 S BARRINGTON AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-7939
Country	:	US
Telephone Number	:	310-770-2762
Fax Number	:

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

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	03/21/2022

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