Organization
SELVAN MD A PROFESSIONAL MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRADEEP SELVAN MD (CEO)
(267) 391-7459
Entity
Organization
Contact information
Practice address
3630 E IMPERIAL HWY, LYNWOOD, CA 90262-2609
(310) 900-8900
Mailing address
3705 W PICO BLVD # 991, LOS ANGELES, CA 90019-3451
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
—
—
2084A2900X
Neurocritical Care Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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