Healthcare Provider Details

I. General information

NPI: 1831398601
Provider Name (Legal Business Name): PIPER ANN CALASANTI-AYUSTE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2007
Last Update Date: 10/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 SAWTELLE BLVD APT 308
LOS ANGELES CA
90066-1656
US

IV. Provider business mailing address

3280 SAWTELLE BLVD APT 308
LOS ANGELES CA
90066-1656
US

V. Phone/Fax

Practice location:
  • Phone: 630-212-9470
  • Fax:
Mailing address:
  • Phone: 630-212-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA100102
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: