Individual
DANYL L FAKHRUTDINOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11333 N SEPULVEDA BLVD, MISSION HILLS, CA 91345-1116
(818) 869-7200
Mailing address
PO BOX 960, MISSION HILLS, CA 91346-9602
(818) 837-5559
(818) 792-4793
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA57371
CA
Other
Enumeration date
10/18/2019
Last updated
10/20/2023
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