Organization
INDRAVADAN A DAVE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INDRAVADAN A DAVE M.D. (OWNER PRES)
(213) 389-5570
Entity
Organization
Contact information
Practice address
274 ONE AND HALF S RAMPART BLVD, LOS ANGELES, CA 90057-1404
(213) 389-5570
(213) 389-5578
Mailing address
274 ONE AND HALF S RAMPART BLVD, LOS ANGELES, CA 90057-1404
(213) 389-5570
(213) 389-5578
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
C41876
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C41876
MEDICAL LICENSE
CA
Enumeration date
02/07/2007
Last updated
08/22/2020
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