Individual
VADIM GELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4549 WHITE OAK PL, ENCINO, CA 91316-4334
(310) 936-7523
Mailing address
4549 WHITE OAK PL, ENCINO, CA 91316-4334
(310) 936-7523
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/03/2020
Last updated
04/03/2020
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