Provider Demographics
NPI:1184146425
Name:IWAHASHI, PAUL HIROMI (RN)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:HIROMI
Last Name:IWAHASHI
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1627 N GRAND OAKS AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1915
Mailing Address - Country:US
Mailing Address - Phone:626-345-5988
Mailing Address - Fax:
Practice Address - Street 1:1627 N GRAND OAKS AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91104-1915
Practice Address - Country:US
Practice Address - Phone:213-739-7315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282800163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health