Provider Demographics
NPI:1073896395
Name:TERMEH, HEDIEH (PA-C)
Entity Type:Individual
Prefix:MS
First Name:HEDIEH
Middle Name:
Last Name:TERMEH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 ROSCOE BLVD
Mailing Address - Street 2:SUIT 1-A
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-1258
Mailing Address - Country:US
Mailing Address - Phone:818-894-7564
Mailing Address - Fax:
Practice Address - Street 1:16300 ROSCOE BLVD
Practice Address - Street 2:SUIT 1-A
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91406-1258
Practice Address - Country:US
Practice Address - Phone:818-894-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21339363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant