# GINA HABEEB PHYSICIAN ASSISTANT INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** VITALITY CARE CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730936402
- **Authorized official:** GINA HABEEB PA-C (OWNER)
- **Authorized official phone:** (310) 619-7370

## Contact information

- **Practice address:** 2790 SKYPARK DR STE 210, TORRANCE, CA 90505-5388
- **Practice address phone:** (310) 619-7370
- **Practice address fax:** (888) 451-7370
- **Mailing address:** 3400 BAHIA PL, RIVERSIDE, CA 92507-4023
- **Mailing address phone:** (310) 619-7370
- **Mailing address fax:** (888) 451-3500

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | — | NULL | — |
| 363AS0400X | Surgical Physician Assistant | — | — | — |
| 363LP2300X | Primary Care Nurse Practitioner | — | NULL | Yes |
| 363LP2300X | Primary Care Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2024
- **Last updated:** 05/01/2024