Individual
GRAHAM VALLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4867 W SUNSET BLVD, LOS ANGELES, CA 90027-5969
(833) 574-2273
Mailing address
1335 SIERRA ALTA WAY, LOS ANGELES, CA 90069-1733
(603) 321-6461
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
95001944
CA
Other
Enumeration date
12/20/2022
Last updated
09/26/2023
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