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Individual

IRINA B GANELIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
16661 VENTURA BLVD, SUITE 523, ENCINO, CA 91436-1914
(818) 394-0003
Mailing address
9663 SANTA MONICA BLVD # 396, BEVERLY HILLS, CA 90210-4303
(310) 773-3396

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A99531
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CX658A
PTAN
Enumeration date
04/23/2009
Last updated
06/01/2012
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