Individual
IAN ANTHONY NOVOTNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.T.
Contact information
Practice address
9201 W SUNSET BLVD, M120, WEST HOLLYWOOD, CA 90069-3701
(310) 246-1050
Mailing address
9201 W SUNSET BLVD, M120, WEST HOLLYWOOD, CA 90069-3701
(310) 246-1050
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT28753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205559183
TAX ID
CA
01
—
PT28753
LICENSE
CA
Enumeration date
09/20/2006
Last updated
04/02/2013
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