Individual
CHRIS T SELVAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16946 BURBANK BLVD, SUITE 106, ENCINO, CA 91316-1869
(818) 990-0179
(818) 990-0814
Mailing address
16946 BURBANK BLVD, SUITE 106, ENCINO, CA 91316-1869
(818) 990-0179
(818) 990-0814
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
A30587
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A305870
—
CA
Enumeration date
01/06/2007
Last updated
07/31/2008
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