Organization
HHSA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HANNA KHAZAELI (PHN)
(760) 740-4291
Entity
Organization
Contact information
Practice address
14002 TIERRA BONITA RD, POWAY, CA 92064-3452
(760) 740-4291
Mailing address
14002 TIERRA BONITA RD, POWAY, CA 92064-3452
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
548889
CA
Other
Enumeration date
03/07/2007
Last updated
08/22/2020
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