Provider Demographics
NPI:1285052480
Name:SILETZ, ANAAR EASTOAK (MD, PH D)
Entity type:Individual
Prefix:
First Name:ANAAR
Middle Name:EASTOAK
Last Name:SILETZ
Suffix:
Gender:F
Credentials:MD, PH D
Other - Prefix:
Other - First Name:ANAAR
Other - Middle Name:
Other - Last Name:EASTOAK-SILETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PH D
Mailing Address - Street 1:10833 LE CONTE AVE
Mailing Address - Street 2:72-227 CHS
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-3075
Mailing Address - Country:US
Mailing Address - Phone:510-219-5504
Mailing Address - Fax:
Practice Address - Street 1:757 WESTWOOD PLZ
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-206-6766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA140229208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery