Provider Demographics
NPI:1447358981
Name:GALFAIAN, ANAIT (MD)
Entity type:Individual
Prefix:
First Name:ANAIT
Middle Name:
Last Name:GALFAIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 W BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-1208
Mailing Address - Country:US
Mailing Address - Phone:818-241-2103
Mailing Address - Fax:818-241-1090
Practice Address - Street 1:445 W BROADWAY
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-1208
Practice Address - Country:US
Practice Address - Phone:818-241-2103
Practice Address - Fax:818-241-1090
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA38864207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A388640Medicaid
CA080005537OtherMEDICARE RR
CAWA38864AMedicare PIN
CAA85200Medicare UPIN