Provider Demographics
NPI:1881640456
Name:GHARIBEH REED, MAHA (NP)
Entity Type:Individual
Prefix:
First Name:MAHA
Middle Name:
Last Name:GHARIBEH REED
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2103B HUNTINGTON LN
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-4308
Mailing Address - Country:US
Mailing Address - Phone:310-869-1295
Mailing Address - Fax:818-587-2493
Practice Address - Street 1:2801 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-1737
Practice Address - Country:US
Practice Address - Phone:562-933-2000
Practice Address - Fax:818-587-2493
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CANP10354363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00235794OtherRAILROAD MEDICARE
CAP44902Medicare UPIN
CAWNP10354BMedicare ID - Type Unspecified