Provider Demographics
NPI:1407818875
Name:BELEZ, AIKANE L (MSED, ATC, CEAS)
Entity Type:Individual
Prefix:MR
First Name:AIKANE
Middle Name:L
Last Name:BELEZ
Suffix:
Gender:M
Credentials:MSED, ATC, CEAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3889 FREDONIA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1211
Mailing Address - Country:US
Mailing Address - Phone:312-550-6025
Mailing Address - Fax:
Practice Address - Street 1:3889 FREDONIA DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1211
Practice Address - Country:US
Practice Address - Phone:312-550-6025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9682255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer