Provider Demographics
NPI:1992392898
Name:ASEFIRAD, ANAHITA PARISA (PA-C)
Entity Type:Individual
Prefix:
First Name:ANAHITA
Middle Name:PARISA
Last Name:ASEFIRAD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 KLUMP AVE UNIT 302
Mailing Address - Street 2:
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91601-3780
Mailing Address - Country:US
Mailing Address - Phone:408-835-4422
Mailing Address - Fax:
Practice Address - Street 1:5127 KLUMP AVE UNIT 302
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91601-3780
Practice Address - Country:US
Practice Address - Phone:408-835-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-25
Last Update Date:2020-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant