Individual
MR. MARAT SHPOLYANSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.P.
Contact information
Practice address
1201 S VICTORY BLVD STE 206, BURBANK, CA 91502-2793
(747) 271-2701
(310) 693-5384
Mailing address
13920 EMELITA ST, VAN NUYS, CA 91401-4339
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
806846
CA
363LA2200X
Adult Health Nurse Practitioner
95000350
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95000350
CA
Other
Enumeration date
10/01/2012
Last updated
08/07/2025
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