Individual
DR. MITRA TAHVILDARIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., AGNP, CFMP
Contact information
Practice address
15840 VENTURA BLVD, 301, ENCINO, CA 91436-2932
(818) 917-2371
Mailing address
15840 VENTURA BLVD STE 301, ENCINO, CA 91436-2932
(818) 917-2371
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
95003672
CA
Other
Enumeration date
01/25/2016
Last updated
03/08/2021
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