Healthcare Provider Details

I. General information

NPI: 1912590662
Provider Name (Legal Business Name): PARVANEH A ARBANI RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2021
Last Update Date: 04/05/2023
Certification Date: 04/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22030 SHERMAN WAY STE 211
CANOGA PARK CA
91303-1882
US

IV. Provider business mailing address

14457 ROSCOE BLVD
PANORAMA CITY CA
91402-3012
US

V. Phone/Fax

Practice location:
  • Phone: 818-810-5947
  • Fax:
Mailing address:
  • Phone: 818-810-5947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number1912590662
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number847269
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: