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General NPI Number Information
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NPI Number | 1356134803
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Entity Type | Individual
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Provider Name | ARMANDO CANLAS
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Gender | Male
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 6816 PACIFIC BLVD STE 210
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4654
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Country | US
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Telephone | 818-754-7986
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Fax |
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Provider Business Mailing Address
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Address Line | 1017 E GARFIELD AVE
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City | GLENDALE
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State | CA
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Zip | 91205-2910
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F05250165
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License Number State | CA
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