Individual
ILLIA KOVALEV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4533 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-2950
(818) 849-6755
Mailing address
4533 VAN NUYS BLVD STE 302, SHERMAN OAKS, CA 91403-2950
(818) 849-6755
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
0002615765-0001-5
CA
Other
Enumeration date
05/14/2012
Last updated
05/14/2012
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