Basic Information
| Provider Information | |||||||||
| NPI: | 1821485392 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ASNAKE | ||||||||
| FirstName: | BETELEHEM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5767 W CENTURY BLVD SUITE 400 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900955631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3103018707 | ||||||||
| FaxNumber: | 3103018751 | ||||||||
| Practice Location | |||||||||
| Address1: | 757 WESTWOOD PLZ STE 3325 | ||||||||
| Address2: | |||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900951911 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102673897 | ||||||||
| FaxNumber: | 3102673899 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/22/2015 | ||||||||
| LastUpdateDate: | 11/23/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/23/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207L00000X | A148601 | CA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.