Provider Demographics
NPI:1407723125
Name:TONOYAN, GRACE ANI
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:ANI
Last Name:TONOYAN
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 1:144 S DOHENY DR APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-2944
Mailing Address - Country:US
Mailing Address - Phone:310-550-5566
Mailing Address - Fax:310-861-1164
Practice Address - Street 1:450 N BEDFORD DR STE 200
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4306
Practice Address - Country:US
Practice Address - Phone:310-550-5566
Practice Address - Fax:310-861-1164
Is Sole Proprietor?:No
Enumeration Date:2025-10-17
Last Update Date:2025-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL9923174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist