Individual
ELENA KHAVSHABA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2621 HONOLULU AVE, MONTROSE, CA 91020-1706
(818) 726-7220
Mailing address
1234 RICHARD PL, GLENDALE, CA 91206-3463
(818) 726-7220
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F11220384
CA
Other
Enumeration date
11/28/2022
Last updated
04/28/2023
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