Individual
DR. ANITA SUSAN PAKULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1250 LA VENTA DR, 105, WESTLAKE VILLAGE, CA 91361-3702
(805) 494-6920
(805) 494-6922
Mailing address
10833 LE CONTE AVE, 52-121 CHS, LOS ANGELES, CA 90095-3075
(805) 494-6920
(805) 494-6922
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G71177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1205869625
CCS PANELED PROVIDER
CA
05
—
1205869625
—
CA
Enumeration date
07/09/2006
Last updated
05/21/2013
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