Individual
JENANAN PRAKASHA VAIRAVAMURTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 SAN PABLO ST FL 2, LOS ANGELES, CA 90033-5313
(323) 442-8541
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-8541
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A136222
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2010
Last updated
11/27/2023
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