Provider Demographics
NPI:1710118476
Name:KIZHAKKEVEETTIL, ANUPAMA (, BAMS, MAOM)
Entity Type:Individual
Prefix:MRS
First Name:ANUPAMA
Middle Name:
Last Name:KIZHAKKEVEETTIL
Suffix:
Gender:F
Credentials:, BAMS, MAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16040 LEFFINGWELL RD UNIT 30
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-3121
Mailing Address - Country:US
Mailing Address - Phone:562-631-0152
Mailing Address - Fax:
Practice Address - Street 1:16200 E AMBER VALLEY DR
Practice Address - Street 2:SOUTHERN CALIFORNIA UNIVERSITY OF HEALTH SCIENCES
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604
Practice Address - Country:US
Practice Address - Phone:562-947-8755
Practice Address - Fax:562-902-3398
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12658171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist