Provider Demographics
NPI:1891911038
Name:ANASTASIU, DANIELLE ZENOVIE (PA)
Entity Type:Individual
Prefix:
First Name:DANIELLE ZENOVIE
Middle Name:
Last Name:ANASTASIU
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 S GREENWICH ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-2342
Mailing Address - Country:US
Mailing Address - Phone:714-206-7055
Mailing Address - Fax:
Practice Address - Street 1:1400 S GRAND AVE STE 707
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90015-2881
Practice Address - Country:US
Practice Address - Phone:213-839-1119
Practice Address - Fax:213-839-1120
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19108363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1891911038OtherNPI