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Individual

BRIAN MY HA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1700 ADAMS AVE, COSTA MESA, CA 92626-4865
(714) 556-2288
Mailing address
521 SHELLEY ST, SANTA ANA, CA 92703-4221
(714) 929-8733

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
413011
CA

Other

Enumeration date
02/01/2019
Last updated
02/01/2019
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