Provider Demographics
NPI:1346434297
Name:KILANI, SUHEIR (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SUHEIR
Middle Name:
Last Name:KILANI
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 1:6535 MONTAIRE ST
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1057
Mailing Address - Country:US
Mailing Address - Phone:714-610-2584
Mailing Address - Fax:877-306-3061
Practice Address - Street 1:9918 KATELLA AVE
Practice Address - Street 2:C
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6465
Practice Address - Country:US
Practice Address - Phone:714-625-8320
Practice Address - Fax:714-583-7660
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2012-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18023363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18023OtherLICENSE