Provider Demographics
NPI:1659231876
Name:GOLIAN, LEILA KHANA
Entity type:Individual
Prefix:
First Name:LEILA
Middle Name:KHANA
Last Name:GOLIAN
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 1:470 S HOLT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-4017
Mailing Address - Country:US
Mailing Address - Phone:310-492-3129
Mailing Address - Fax:
Practice Address - Street 1:470 S HOLT AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4017
Practice Address - Country:US
Practice Address - Phone:310-492-3129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-12
Last Update Date:2025-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant