Organization
EVOLVE ANTI-AGING & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANI ZAGHIKIAN (ADMINISTRATOR)
(818) 606-2459
Entity
Organization
Contact information
Practice address
16500 VENTURA BLVD STE 420, ENCINO, CA 91436-2062
(818) 600-7600
(818) 334-2497
Mailing address
16500 VENTURA BLVD STE 420, ENCINO, CA 91436-2062
(818) 600-7600
(818) 334-2497
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
—
—
251F00000X
Home Infusion Agency
—
—
261Q00000X
Clinic/Center
Primary
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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