Basic Information
| Provider Information | |||||||||
| NPI: | 1508369331 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | HAMPARSUMIAN | ||||||||
| FirstName: | ANAHID | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20361 VIA VARADERO | ||||||||
| Address2: | |||||||||
| City: | YORBA LINDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928873138 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7143294639 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1200 NORTH STATE STREET | ||||||||
| Address2: | CT A7D | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3234097556 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2018 | ||||||||
| LastUpdateDate: | 03/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.