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Individual

DR. GERALD JAMES KAVANAGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
637 LUCAS AVE, SUITE 402, LOS ANGELES, CA 90017-1912
(213) 977-2171
Mailing address
443 19TH ST, SANTA MONICA, CA 90402-2431
(310) 394-4405

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G18772
CA

Other

Enumeration date
08/30/2006
Last updated
07/09/2007
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