Individual
MAHUA BISWAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4640 ADMIRALTY WAY, SUITE 102, MARINA DEL REY, CA 90292-6629
(310) 836-1574
(310) 836-6925
Mailing address
4640 ADMIRALTY WAY, SUITE 102, MARINA DEL REY, CA 90292-6629
(310) 836-1574
(310) 836-6925
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
A48575
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A485750
—
CA
Enumeration date
05/19/2006
Last updated
06/14/2012
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