Provider Demographics
NPI:1821825399
Name:NOOR, MEGAN IMREH (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:IMREH
Last Name:NOOR
Suffix:
Gender:
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 1:17935 CALIFA ST
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1011
Mailing Address - Country:US
Mailing Address - Phone:310-383-3851
Mailing Address - Fax:
Practice Address - Street 1:1127 WILSHIRE BLVD STE 1112
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4002
Practice Address - Country:US
Practice Address - Phone:310-383-3851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64666363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant