Provider Demographics
NPI:1518261981
Name:HA, ESTHER WONSON (MHS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:ESTHER
Middle Name:WONSON
Last Name:HA
Suffix:
Gender:F
Credentials:MHS, PA-C
Other - Prefix:
Other - First Name:WON
Other - Middle Name:SON
Other - Last Name:HA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 E BEVERLY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-4300
Mailing Address - Country:US
Mailing Address - Phone:323-278-4400
Mailing Address - Fax:323-278-4401
Practice Address - Street 1:101 E BEVERLY BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:MONTEBELLO
Practice Address - State:CA
Practice Address - Zip Code:90640-4300
Practice Address - Country:US
Practice Address - Phone:323-278-4400
Practice Address - Fax:323-278-4401
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2013-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA21136363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical