Provider Demographics
NPI:1043083488
Name:GOKHGAUZER, ANDREY
Entity Type:Individual
Prefix:
First Name:ANDREY
Middle Name:
Last Name:GOKHGAUZER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21051 WARNER CENTER LN STE 100
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6566
Mailing Address - Country:US
Mailing Address - Phone:424-335-5505
Mailing Address - Fax:
Practice Address - Street 1:21051 WARNER CENTER LN STE 100
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6566
Practice Address - Country:US
Practice Address - Phone:424-335-5505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28298225100000X
CA13306235Z00000X
CA4089225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist