MEDICARE: JULIA SVERDLOVA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	A063261	CA

General Provider Information

NPI Number	:	1205933058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIA SVERDLOVA M.D.

Provider Business Mailing Address
First Line	:	1411 TOWER GROVE DR
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90210-2139
Country	:	US
Telephone Number	:	310-654-0900
Fax Number	:	310-285-9762

Provider Business Practice Location Address
First Line	:	8920 WILSHIRE BLVD STE 414
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90211-2004
Country	:	US
Telephone Number	:	310-289-1215
Fax Number	:	310-285-9762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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