Healthcare Provider Details

I. General information

NPI: 1568758548
Provider Name (Legal Business Name): ANNA RYABETS-LIENHARD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 06/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4650 W SUNSET BLVD
LOS ANGELES CA
90027-6062
US

IV. Provider business mailing address

6430 SUNSET BVLD. SUITE 600
LOS ANGELES CA
90028-7900
US

V. Phone/Fax

Practice location:
  • Phone: 323-361-2109
  • Fax: 323-361-3891
Mailing address:
  • Phone: 323-361-2337
  • Fax: 323-361-8491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number2OA11301
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: