Individual
ANTON FEDOROVICH SHANIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4838 LAUREL CANYON BLVD, NORTH HOLLYWOOD, CA 91607-3717
(818) 506-4455
Mailing address
17200 BURBANK BLVD APT 109, ENCINO, CA 91316-1889
(310) 924-0286
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
95031622
CA
363LF0000X
Family Nurse Practitioner
Primary
95031622
CA
Other
Enumeration date
08/13/2024
Last updated
02/11/2026
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