Provider Demographics
NPI:1285418749
Name:MARKOV, YAROSLAVA (MSN, ARNP, FNP)
Entity type:Individual
Prefix:
First Name:YAROSLAVA
Middle Name:
Last Name:MARKOV
Suffix:
Gender:F
Credentials:MSN, ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3819 SHERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5034
Mailing Address - Country:US
Mailing Address - Phone:424-355-3555
Mailing Address - Fax:
Practice Address - Street 1:3819 SHERVIEW DR
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5034
Practice Address - Country:US
Practice Address - Phone:424-355-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026705207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine