Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | A107994 | CA |
NPI | 1033308358 |
---|---|
Provider Name | Ani Khondkaryan |
First Address | Panorama City, CA 91402-5423 |
Second Address | Panorama City, CA 91402-5423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 06/12/2021 |