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General NPI Number Information
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NPI Number | 1558317677
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Entity Type | Individual
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Provider Name | MAXINE S JOCHELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/23/2024
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Provider Practice Location Address
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Address Line | 8750 WILSHIRE BLVD STE 100
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2708
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Country | US
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Telephone | 310-689-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 1275 YORK AVE
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City | NEW YORK
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State | NY
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Zip | 10065-6007
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Country | US
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Telephone | 212-639-2190
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | G37530
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License Number State | CA
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