Healthcare Provider Details

I. General information

NPI: 1043271620
Provider Name (Legal Business Name): IVOR GEFT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 08/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8631 W 3RD ST #445E
LOS ANGELES CA
90048-5901
US

IV. Provider business mailing address

99 N L A CIENEGA BL VD #103
BEVERLY HILLS CA
90211
US

V. Phone/Fax

Practice location:
  • Phone: 310-659-7537
  • Fax: 310-623-1142
Mailing address:
  • Phone: 310-623-1146
  • Fax: 310-623-1142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberA37160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: