Healthcare Provider Details

I. General information

NPI: 1134426679
Provider Name (Legal Business Name): FARNOUSH ARASTEHMANESH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 02/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 VETERAN AVE 301
LOS ANGELES CA
90025-4500
US

IV. Provider business mailing address

1851 VETERAN AVE 301
LOS ANGELES CA
90025-4500
US

V. Phone/Fax

Practice location:
  • Phone: 310-478-0068
  • Fax:
Mailing address:
  • Phone: 310-478-0068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number4928
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: