Provider Demographics
NPI:1346571833
Name:ASLAN, IVY (MD)
Entity Type:Individual
Prefix:DR
First Name:IVY
Middle Name:
Last Name:ASLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BRANNAN ST
Mailing Address - Street 2:APT 443
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-6001
Mailing Address - Country:US
Mailing Address - Phone:617-692-0879
Mailing Address - Fax:415-476-8214
Practice Address - Street 1:513 PARNASSUS AVE
Practice Address - Street 2:ROOM S672D
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-2205
Practice Address - Country:US
Practice Address - Phone:415-353-7337
Practice Address - Fax:415-476-8214
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99943174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist