Provider Demographics
NPI:1437600772
Name:ANIA MARIAM GAPELEH, M.D., INC.
Entity Type:Organization
Organization Name:ANIA MARIAM GAPELEH, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:ANIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAPELEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-882-8401
Mailing Address - Street 1:5333 VELOZ AVE
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5333 VELOZ AVE
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4127
Practice Address - Country:US
Practice Address - Phone:310-882-8401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-21
Last Update Date:2016-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA133064207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty