Provider Demographics
NPI:1932657236
Name:KELARTINIAN, ANGEL
Entity Type:Individual
Prefix:MRS
First Name:ANGEL
Middle Name:
Last Name:KELARTINIAN
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 1:3600 WILSHIRE BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2632
Mailing Address - Country:US
Mailing Address - Phone:626-577-8480
Mailing Address - Fax:
Practice Address - Street 1:3600 WILSHIRE BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2632
Practice Address - Country:US
Practice Address - Phone:626-577-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
No171M00000XOther Service ProvidersCase Manager/Care Coordinator