Organization
DHANALAKSHMI P GANESAN MD, SC
Active
Parent organization
DHANALAKSHMI P GANESAN MD, SC
Other names
Grand Medical Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
DHANALAKSHMI P GANESAN MD, SC
Authorized official
DR. DHANA GANESAN M.D. (MEDICAL DIRECTOR)
(708) 405-6200
Entity
Organization
Contact information
Practice address
7357 NORTH AVE, RIVER FOREST, IL 60305-1230
(708) 405-6200
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/15/2012
Last updated
03/15/2012
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