Basic Information
| Provider Information | |||||||||
| NPI: | 1003140856 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHAGVANJEE | ||||||||
| FirstName: | ANJNA | ||||||||
| MiddleName: | |||||||||
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| Credential: | L.AC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1414 N.EDGEMONT | ||||||||
| Address2: | APT. C | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132915680 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3367 GLENDALE BLVD | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900391825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2132915680 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/28/2009 | ||||||||
| LastUpdateDate: | 09/28/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 171100000X | AC12857 | CA | Y | Other Service Providers | Acupuncturist |
No ID Information.