MEDICARE: SA RAH SHEEN NP

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	363LA2200X	Adult Health Nurse Practitioner	309951	NY

General Provider Information

NPI Number	:	1740894104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SA RAH SHEEN NP

Provider Business Mailing Address
First Line	:	4140 W 190TH ST
Second Line	:
City	:	TORRANCE
State	:	CA
Zip	:	90504-5513
Country	:	US
Telephone Number	:	310-867-1889
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 N SAN VICENTE BLVD
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1810
Country	:	US
Telephone Number	:	310-423-9331
Fax Number	:	310-423-9399

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

Provider Enumeration Date	:	09/03/2020
Last Update Date	:	10/06/2022

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Directions to “ SA RAH SHEEN NP” Practice Location

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