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NPI Code Detail

MEDICARE: MAXINE S JOCHELSON M.D.

MEDICARE: MAXINE S JOCHELSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology PhysicianG37530CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200G375300OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1558317677
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAXINE S JOCHELSON M.D.
Provider Business Mailing Address
First Line : 1275 YORK AVE
Second Line :
City : NEW YORK
State : NY
Zip : 10065-6007
Country : US
Telephone Number : 212-639-2190
Fax Number :
Provider Business Practice Location Address
First Line : 8750 WILSHIRE BLVD STE 100
Second Line :
City : BEVERLY HILLS
State : CA
Zip : 90211-2708
Country : US
Telephone Number : 310-689-3100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 10/23/2024

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