Healthcare Provider Details

I. General information

NPI: 1851515548
Provider Name (Legal Business Name): JOSEPHA INEZ SELETZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 04/09/2024
Certification Date: 04/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9012 W OLYMPIC BLVD
BEVERLY HILLS CA
90211-3516
US

IV. Provider business mailing address

9012 W OLYMPIC BLVD
BEVERLY HILLS CA
90211-3516
US

V. Phone/Fax

Practice location:
  • Phone: 310-913-2120
  • Fax:
Mailing address:
  • Phone: 310-913-2120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG35414
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License NumberG35414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: