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Individual

DR. MINDIA GABICHVADZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
9713 SANTA MONICA BLVD STE 201, BEVERLY HILLS, CA 90210-4236
(310) 564-5400
(844) 654-2900
Mailing address
9713 SANTA MONICA BLVD STE 201, BEVERLY HILLS, CA 90210-4236
(310) 564-5400
(844) 654-2900

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY34139
CA
103TC0700X
Clinical Psychologist
PSY34139
CA

Other

Enumeration date
10/07/2009
Last updated
07/21/2023
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