Provider Demographics
NPI:1215051974
Name:BEBAWI, NORA HANNA (MSPA-C)
Entity type:Individual
Prefix:MRS
First Name:NORA
Middle Name:HANNA
Last Name:BEBAWI
Suffix:
Gender:F
Credentials:MSPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22191 WAYSIDE
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-4514
Mailing Address - Country:US
Mailing Address - Phone:949-235-3031
Mailing Address - Fax:
Practice Address - Street 1:2621 S BRISTOL ST STE 105
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704
Practice Address - Country:US
Practice Address - Phone:714-617-4833
Practice Address - Fax:951-787-4962
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18542363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical