Individual
JUDAH JOSHUA MIRVISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
939 ELLIS ST FL 5, SAN FRANCISCO, CA 94109-7714
(415) 833-2292
(702) 529-4030
Mailing address
2120 FUNSTON AVE, SAN FRANCISCO, CA 94116-1903
(415) 710-2179
(702) 529-4030
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A178097
CA
390200000X
Student in an Organized Health Care Education/Training Program
D0086815
MD
Other
Enumeration date
03/28/2017
Last updated
01/06/2023
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