Provider Demographics
NPI:1124681770
Name:KAHSAY, MEDHIN (FNP-C)
Entity type:Individual
Prefix:
First Name:MEDHIN
Middle Name:
Last Name:KAHSAY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25252 DENNY RD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7051
Mailing Address - Country:US
Mailing Address - Phone:310-590-5027
Mailing Address - Fax:
Practice Address - Street 1:25252 DENNY RD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-7051
Practice Address - Country:US
Practice Address - Phone:310-590-5027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-19
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAF04190228363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily