Provider Demographics
NPI:1417421850
Name:HEALTH ACCESS FOR ALL INC
Entity Type:Organization
Organization Name:HEALTH ACCESS FOR ALL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANOONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-625-4649
Mailing Address - Street 1:P.O. BOX 57130
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3851
Mailing Address - Country:US
Mailing Address - Phone:213-413-2222
Mailing Address - Fax:213-483-1711
Practice Address - Street 1:1030 GARDENA BLVD
Practice Address - Street 2:
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4956
Practice Address - Country:US
Practice Address - Phone:424-222-8800
Practice Address - Fax:424-222-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-18
Last Update Date:2019-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center