Individual
GEORGE VATAKENCHERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1505 N EDGEMONT ST, KAISER PERMANENTE, LOS ANGELES, CA 90027-5209
(323) 783-7668
Mailing address
10980 WELLWORTH AVE, APT 212, LOS ANGELES, CA 90024-6256
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A83475
CA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A83475
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A834750
MEDICAL
CA
Enumeration date
07/08/2006
Last updated
11/29/2021
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