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Individual

DR. KETEVAN GENDZEKHADZE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1500 DUARTE RD, DUARTE, CA 91010-3012
(626) 256-8621
Mailing address
1817 2ND ST APT 26, DUARTE, CA 91010-1822
(626) 251-7030

Taxonomy

Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
DRK38
CA

Other

Enumeration date
12/13/2011
Last updated
12/13/2011
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