Provider Demographics
NPI:1073688255
Name:BIRHAN, ZUBEIDA HASSEN (PA)
Entity Type:Individual
Prefix:MRS
First Name:ZUBEIDA
Middle Name:HASSEN
Last Name:BIRHAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90057-3158
Mailing Address - Country:US
Mailing Address - Phone:213-263-2468
Mailing Address - Fax:213-484-8750
Practice Address - Street 1:2065 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-3158
Practice Address - Country:US
Practice Address - Phone:213-263-2468
Practice Address - Fax:213-484-8750
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011462363AM0700X
CA18176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY011462OtherSTATE LICENSE