Individual
DR. MARY ALICE VIJJESWARAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5841
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6110
(617) 732-5500
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
266053
MA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A147375
CA
207R00000X
Internal Medicine Physician
252000
MA
Other
Enumeration date
06/21/2012
Last updated
12/13/2021
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