Provider Demographics
NPI:1801112057
Name:CELINA M. NADELMAN, MD, A MEDICAL CORPORATION
Entity type:Organization
Organization Name:CELINA M. NADELMAN, MD, A MEDICAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:LABORATORY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CELINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:NADELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-702-6701
Mailing Address - Street 1:9663 SANTA MONICA BLVD
Mailing Address - Street 2:STE 439
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4303
Mailing Address - Country:US
Mailing Address - Phone:310-702-6701
Mailing Address - Fax:310-935-3039
Practice Address - Street 1:1125 S BEVERLY DR
Practice Address - Street 2:STE 602
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-1148
Practice Address - Country:US
Practice Address - Phone:310-702-6701
Practice Address - Fax:310-276-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-13
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A70801Medicare PIN