Provider Demographics
NPI:1174335301
Name:FHER PHYSICIAN ASSISTANT INC.
Entity type:Organization
Organization Name:FHER PHYSICIAN ASSISTANT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVERARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:MEJIA
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:133-093-8752
Mailing Address - Street 1:11513 CLAYMORE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:90670-3101
Mailing Address - Country:US
Mailing Address - Phone:213-309-3875
Mailing Address - Fax:
Practice Address - Street 1:20311 SW BIRCH ST STE 100
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-1778
Practice Address - Country:US
Practice Address - Phone:949-269-6142
Practice Address - Fax:888-507-7138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty