Provider Demographics
NPI:1417638115
Name:MASSACHI, ORENA (PA)
Entity Type:Individual
Prefix:
First Name:ORENA
Middle Name:
Last Name:MASSACHI
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:224 N FAIR OAKS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3618
Mailing Address - Country:US
Mailing Address - Phone:626-696-1400
Mailing Address - Fax:626-696-1451
Practice Address - Street 1:1127 WILSHIRE BLVD STE 800
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-3909
Practice Address - Country:US
Practice Address - Phone:213-839-1119
Practice Address - Fax:213-839-1120
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2024-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA63743363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty