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General NPI Number Information
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NPI Number | 1053104364
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Entity Type | Organization
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Legal Business Name | ANI OVSEPIAN, PHYSICIAN ASSISTANT, PC
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Dates
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Enumeration Date | 05/28/2025
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 16661 VENTURA BLVD STE 313
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City | ENCINO
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State | CA
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Zip | 91436-1956
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Country | US
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Telephone | 818-369-9807
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 9131
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City | GLENDALE
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State | CA
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Zip | 91226-0131
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Country | US
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Telephone | 818-369-9807
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | ANI OVSEPIAN
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Credential | PA-C
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Telephone | 818-369-9807
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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