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Organization

ALEXANDER SELIVERSTOV MD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALEXANDER SELIVERSTOV M.D. (SOLE OWNER)
(818) 888-7815
Entity
Organization

Contact information

Practice address
18300 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(818) 885-8500
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A76611
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A76611
CA

Other

Enumeration date
03/28/2006
Last updated
11/27/2012
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