Individual
GENNADY SHIFERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-0001
(310) 301-6800
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 301-6800
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A109770
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1097700
—
CA
Enumeration date
05/04/2009
Last updated
12/15/2021
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