Healthcare Provider Details

I. General information

NPI: 1699334813
Provider Name (Legal Business Name): ANJEL KHOUBIAN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9301 WILSHIRE BLVD STE 313
BEVERLY HILLS CA
90210-6131
US

IV. Provider business mailing address

6522 W 6TH ST
LOS ANGELES CA
90048-4716
US

V. Phone/Fax

Practice location:
  • Phone: 818-538-7981
  • Fax: 760-797-1845
Mailing address:
  • Phone: 818-426-8462
  • Fax: 760-797-1845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC18513
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: