| Maria I. Seliverstov, Md Inc. | |
|
4835 Van Nuys Blvd #104 Sherman Oaks CA 91403 | |
| (818) 986-9232 | |
| (818) 986-9716 |
| Full Name | Maria I. Seliverstov, Md Inc. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4835 Van Nuys Blvd, Sherman Oaks, California |
| Authorized Official Name and Position | Maria I. Seliverstov (CEO) |
| Authorized Official Contact | 8189869232 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Maria I. Seliverstov, Md Inc. 4835 Van Nuys Blvd #104 Sherman Oaks CA 91403 Ph: (818) 986-9232 | Maria I. Seliverstov, Md Inc. 4835 Van Nuys Blvd #104 Sherman Oaks CA 91403 Ph: (818) 986-9232 |
| NPI Number | 1841298775 |
|---|---|
| Provider Enumeration Date | 07/13/2005 |
| Last Update Date | 11/06/2007 |
| Medicare PECOS PAC ID | 3072691047 |
|---|---|
| Medicare Enrollment ID | O20080416000624 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841298775 | NPI | - | NPPES |
| 00A669380 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | A066938 (California) | Primary |
| 2084P2900X | Psychiatry & Neurology - Pain Medicine | A066938 (California) | Secondary |
| Provider Name | Maria I Seliverstov |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457520009 PECOS PAC ID: 7618055682 Enrollment ID: I20080416000626 |
| Provider Name | Elham Hamzeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265041511 PECOS PAC ID: 7810202256 Enrollment ID: I20210901003673 |
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