Individual
GELA G MCHEDLISHVILI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12660 RIVERSIDE DR STE 215, NORTH HOLLYWOOD, CA 91607-3430
(818) 487-0040
Mailing address
3421 CONCORD RD, YORK, PA 17402-9001
(717) 851-6040
(717) 851-3190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD063153L
PA
207RN0300X
Nephrology Physician
Primary
C143015
CA
207RN0300X
Nephrology Physician
MD063153L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101971303
—
PA
01
—
111166
GEISINGER
PA
01
—
1567154
GATEWAY-WMG
PA
01
—
1978152
HIGHMARK BLUE SHIELD
PA
01
—
20067552
AMERIHEALTH MERCY-WMG
PA
01
—
211714
JOHNS HOPKINS
PA
01
—
2167388
MAMSI-WMG
PA
01
—
220419
UNISON-WMG
PA
01
—
50071495
CAPITAL BLUE CROSS-WMG
PA
01
—
900186
CAREFIRST MD BCBS
MD
01
—
9566069
AETNA
PA
Enumeration date
05/20/2007
Last updated
02/19/2020
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