Provider Demographics
NPI:1003140856
Name:BHAGVANJEE, ANJNA (LAC)
Entity Type:Individual
Prefix:
First Name:ANJNA
Middle Name:
Last Name:BHAGVANJEE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1414 N.EDGEMONT
Mailing Address - Street 2:APT. C
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027
Mailing Address - Country:US
Mailing Address - Phone:213-291-5680
Mailing Address - Fax:
Practice Address - Street 1:3367 GLENDALE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-1825
Practice Address - Country:US
Practice Address - Phone:213-291-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-28
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12857171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist