Individual
DR. GENADY SHILYANSKY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 16TH ST, SANTA MONICA, CA 90404-1249
(714) 437-7400
(714) 437-7410
Mailing address
17150 NEWHOPE ST, SUITE 507, FOUNTAIN VALLEY, CA 92708-4250
(714) 437-7400
(714) 437-7410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A40487
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A40487
STATE LICENSE
CA
Enumeration date
05/05/2006
Last updated
07/08/2007
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