Basic Information
| Provider Information | |||||||||
| NPI: | 1275277063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CARVUTTO | ||||||||
| FirstName: | HANNAH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17038 SAINT ANDREWS DR | ||||||||
| Address2: | |||||||||
| City: | POWAY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920641225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5599992559 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4929 VAN NUYS BLVD | ||||||||
| Address2: | |||||||||
| City: | SHERMAN OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914031702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8189817111 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/26/2022 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.