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General NPI Number Information
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NPI Number | 1649956715
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Entity Type | Individual
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Provider Name | OLIVIA GRAHM VALADIE
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Gender | Female
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 310-423-3277
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Fax |
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Provider Business Mailing Address
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Address Line | 1820 N LA BREA AVE APT 4
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City | LOS ANGELES
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State | CA
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Zip | 90046-3095
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Country | US
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Telephone | 423-503-9601
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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 | 2085R0205X
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Taxonomy Name | Radiological Physics Physician
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License Number | TBD
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License Number State | CA
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