| Selvan Md A Professional Medical Corporation | |
|
3630 E Imperial Hwy Lynwood CA 90262-2609 | |
| (310) 900-8900 | |
| Not Available |
| Full Name | Selvan Md A Professional Medical Corporation |
|---|---|
| Speciality | Neurological Surgery |
| Location | 3630 E Imperial Hwy, Lynwood, California |
| Authorized Official Name and Position | Pradeep Selvan (CEO) |
| Authorized Official Contact | 2673917459 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Selvan Md A Professional Medical Corporation 3705 W Pico Blvd # 991 Los Angeles CA 90019-3451 Ph: () - | Selvan Md A Professional Medical Corporation 3630 E Imperial Hwy Lynwood CA 90262-2609 Ph: (310) 900-8900 |
| NPI Number | 1851067300 |
|---|---|
| Provider Enumeration Date | 08/16/2021 |
| Last Update Date | 08/16/2021 |
| Certification Date | 08/16/2021 |
| Medicare PECOS PAC ID | 4082011887 |
|---|---|
| Medicare Enrollment ID | O20210921003035 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851067300 | NPI | - | NPPES |
| Provider Name | Pradeep Kumar Selvan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871938092 PECOS PAC ID: 1254669518 Enrollment ID: I20190823001910 |
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