Individual
ALLYSSA RASCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4455 W 117TH ST STE 200, HAWTHORNE, CA 90250-2240
(310) 219-2000
Mailing address
PO BOX 1454, GLENDORA, CA 91740-1454
(951) 533-3203
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA66568
CA
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA66568
PHYSICIAN ASSISTANT BOARD
CA
Enumeration date
12/14/2022
Last updated
06/16/2025
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