Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A15278 | CA |
Y | 2081P2900X | Pain Medicine | 20A15278 | CA |
NPI | 1265816680 |
---|---|
Provider Name | Dr. Alexander Ghatan |
First Address | Encino, CA 91316-4197 |
Second Address | Encino, CA 91316-4197 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2015 |
Last Update Date | 06/07/2020 |