Provider Information for 1235426917
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ANI ASULYAN
Sex: Female
NPI: 1235426917
Last Updated: 2024-12-10
Certification Date: 2024-12-10
Certification Date: 2024-12-10
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1235426917 | ||||||||
| Enumeration Date | 2011-07-01 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 12918 SHERMAN WAY # 189 NORTH HOLLYWOOD, CA 91605-4953 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 18814 CLEARBROOK ST PORTER RANCH, CA 91326-2127 United States Phone: 818-916-8573 | Fax: | ||||||||
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