Individual
ANOUSH KETSOYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2415 LOS AMIGOS ST, LA CRESCENTA, CA 91214-3032
(818) 522-3555
Mailing address
2415 LOS AMIGOS ST, LA CRESCENTA, CA 91214-3032
(818) 522-3555
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/28/2023
Last updated
02/28/2023
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