Provider Demographics
NPI:1326374737
Name:PAHLAVANI, MEHRI (CRNA)
Entity Type:Individual
Prefix:
First Name:MEHRI
Middle Name:
Last Name:PAHLAVANI
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26881 LA ALAMEDA
Mailing Address - Street 2:#334
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-7341
Mailing Address - Country:US
Mailing Address - Phone:817-334-0530
Mailing Address - Fax:817-877-0350
Practice Address - Street 1:26881 LA ALAMEDA
Practice Address - Street 2:#334
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7341
Practice Address - Country:US
Practice Address - Phone:817-334-0530
Practice Address - Fax:817-877-0350
Is Sole Proprietor?:No
Enumeration Date:2009-10-20
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX717828163W00000X, 367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse