Individual
DR. ALEXANDER SELIVERSTOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18300 ROSCOE BLVD, NORTHRIDGE, CA 91325-4105
(818) 885-5375
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A76611
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
A76611
CA
Other
Enumeration date
02/21/2006
Last updated
11/27/2012
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