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General NPI Number Information
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NPI Number | 1225274509
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Entity Type | Organization
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Legal Business Name | ANATOLY POSTOLOV M.D., A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 12/17/2008
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Last Update Date | 12/17/2008
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Provider Practice Location Address
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Address Line | 13749 RIVERSIDE DR STE 200
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2446
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Country | US
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Telephone | 818-501-4838
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Fax | 818-501-4348
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Provider Business Mailing Address
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Address Line | 13749 RIVERSIDE DR STE 200
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City | SHERMAN OAKS
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State | CA
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Zip | 91423-2446
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Country | US
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Telephone | 818-501-4838
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Fax | 818-501-4348
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Authorized Official
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Title or Position | OVNER
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Name | DR. ANATOLY POSTOLOV
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Credential |
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Telephone | 818-501-4838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A72516
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License Number State | CA
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