Basic Information
| Provider Information | |||||||||
| NPI: | 1477042729 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIRA | ||||||||
| FirstName: | HARMANDEEP | ||||||||
| MiddleName: | KAUR | ||||||||
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| OtherOrganizationName: | |||||||||
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| OtherLastName: | HIRA | ||||||||
| OtherFirstName: | HONEY | ||||||||
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| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1000 W CARSON ST | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102223151 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | LAC-DMH 1000 W. CARSON STREET | ||||||||
| Address2: | |||||||||
| City: | TORRANCE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 905022004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102223151 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2018 | ||||||||
| LastUpdateDate: | 10/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 95053148 | CA | N | Nursing Service Providers | Registered Nurse | 163WP0808X | 95053148 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.