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General NPI Number Information
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NPI Number | 1598933665
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Entity Type | Organization
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Legal Business Name | ASYA KUPISK MD INC
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 12/10/2008
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Provider Practice Location Address
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Address Line | 7779 W SUNSET BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90046-3911
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Country | US
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Telephone | 323-876-6649
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Fax | 323-876-1835
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Provider Business Mailing Address
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Address Line | 11323 DONA LOLA DR
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City | STUDIO CITY
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State | CA
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Zip | 91604
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Country | US
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Telephone | 323-876-6649
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Fax | 323-876-1835
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Authorized Official
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Title or Position | PRESIDENT
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Name | ASYA KUPISK
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Credential | MD
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Telephone | 323-876-6649
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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 | A35087
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License Number State | CA
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