Provider Demographics
NPI:1922118017
Name:ATTAI, DEANNA J (MD)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:J
Last Name:ATTAI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:191 S BUENA VISTA ST
Mailing Address - Street 2:SUITE 415
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4554
Mailing Address - Country:US
Mailing Address - Phone:818-333-2555
Mailing Address - Fax:818-333-2559
Practice Address - Street 1:191 S BUENA VISTA ST
Practice Address - Street 2:SUITE 415
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4554
Practice Address - Country:US
Practice Address - Phone:818-333-2555
Practice Address - Fax:818-333-2559
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2010-07-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG85407208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG85407Medicare ID - Type UnspecifiedCALIFORNIA LICENSE #