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General NPI Number Information
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NPI Number | 1790757136
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Entity Type | Individual
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Provider Name | DEBRA R JUDELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 12/14/2009
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Provider Practice Location Address
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Address Line | 414 N CAMDEN DR STE 1100
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4532
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Country | US
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Telephone | 310-278-3400
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Fax | 310-278-1240
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Provider Business Mailing Address
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Address Line | 414 N CAMDEN DR STE 1100
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4532
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Country | US
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Telephone | 310-278-3400
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Fax | 310-278-1240
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G35161
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License Number State | CA
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