Individual
MS. ANISE KEVAKIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 S FREMONT AVE BLDG A-11, ALHAMBRA, CA 91803-8800
(626) 457-4240
Mailing address
10625 BLOOMFIELD ST APT 303, TOLUCA LAKE, CA 91602-4512
(818) 939-3104
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
63023
CA
Other
Enumeration date
07/13/2022
Last updated
07/30/2024
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