Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | E45820 | CA |
Y | 222Z00000X | Podiatrist | E45820 | CA |
NPI | 1033120787 |
---|---|
Provider Name | Charles E Ananian |
First Address | Los Angeles, CA 90063-2326 |
Second Address | Los Angeles, CA 90063-2326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2006 |
Last Update Date | 14/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000E45820 | (05) | CA |
V06595 | (02) | CA |