Provider Demographics
NPI:1366500522
Name:DELAFIELD, JUDITH P (PHD, MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:P
Last Name:DELAFIELD
Suffix:
Gender:F
Credentials:PHD, MD
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Other - First Name:
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Mailing Address - Street 1:435 N ROXBURY DR
Mailing Address - Street 2:STE. #300
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5027
Mailing Address - Country:US
Mailing Address - Phone:310-278-1388
Mailing Address - Fax:310-278-1090
Practice Address - Street 1:435 N ROXBURY DR
Practice Address - Street 2:STE. #300
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-5027
Practice Address - Country:US
Practice Address - Phone:310-278-1388
Practice Address - Fax:310-278-1090
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA48086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA48086Medicare PIN