Individual
DMITRY KHVATSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 ASHBY AVE, BERKELEY, CA 94705-2067
(510) 204-4444
(510) 649-8287
Mailing address
3687 MT DIABLO BLVD STE 200, LAFAYETTE, CA 94549-3746
(916) 854-6975
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A97563
CA
208000000X
Pediatrics Physician
A97563
CA
208M00000X
Hospitalist Physician
Primary
A97563
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A97563
STATE LICENSE
CA
Enumeration date
01/08/2008
Last updated
07/21/2022
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