Provider Demographics
NPI:1164648242
Name:KANOVSKY, FRANK HYMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:HYMAN
Last Name:KANOVSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 N CENTRAL AVE
Mailing Address - Street 2:SUITE 900
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1422
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:655 N CENTRAL AVE
Practice Address - Street 2:SUITE 900
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1422
Practice Address - Country:US
Practice Address - Phone:818-291-4821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG11855207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA38463Medicare UPIN