Provider Demographics
NPI:1235335316
Name:DANA, GELAREH (MD)
Entity Type:Individual
Prefix:DR
First Name:GELAREH
Middle Name:
Last Name:DANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GELAREH
Other - Middle Name:
Other - Last Name:ABEDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5601 DE SOTO AVE
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6701
Mailing Address - Country:US
Mailing Address - Phone:818-719-4834
Mailing Address - Fax:877-776-5490
Practice Address - Street 1:5601 DE SOTO AVE
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6701
Practice Address - Country:US
Practice Address - Phone:818-719-4834
Practice Address - Fax:877-776-5490
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA122910207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB110339Medicare PIN