Provider Information for 1811692908
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MERSEDEH KAVIANY
Sex: Female
NPI: 1811692908
Last Updated: 2024-10-14
Certification Date: 2024-10-14
Certification Date: 2024-10-14
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1811692908 | ||||||||
| Enumeration Date | 2023-03-30 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4510 WILLENS AVE WOODLAND HILLS, CA 91364-3807 United States Phone: 181-842-7778 | Fax: | ||||||||
| Primary Practice Address | 4510 WILLENS AVE WOODLAND HILLS, CA 91364-3807 United States Phone: 181-842-7778 | Fax: | ||||||||
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