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Individual

ALEXANDER ASTAFIEV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
500 E OLIVE AVE STE 103, BURBANK, CA 91501-2171
(818) 861-7902
(818) 861-7385
Mailing address
500 E OLIVE AVE STE 103, BURBANK, CA 91501-2171
(818) 861-7902
(818) 861-7385

Taxonomy

Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1603015574
DRIVERS LICENSE
NV
Enumeration date
11/23/2020
Last updated
11/23/2020
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