Provider Demographics
NPI:1730464132
Name:HOUSHANIAN, MALIHE
Entity Type:Individual
Prefix:
First Name:MALIHE
Middle Name:
Last Name:HOUSHANIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22736 VANOWEN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-2650
Mailing Address - Country:US
Mailing Address - Phone:818-932-9301
Mailing Address - Fax:818-932-9301
Practice Address - Street 1:22736 VANOWEN ST
Practice Address - Street 2:SUITE 205
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-2650
Practice Address - Country:US
Practice Address - Phone:818-932-9301
Practice Address - Fax:818-932-9301
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
6684720001Medicare NSC