Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ILLIA KOVALEV
Active Sole ProprietorILLIA KOVALEV is a Sports Medicine (IM) healthcare provider located in SHERMAN OAKS, California. NPI 1639438435 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine (IM) · SHERMAN OAKS, CA
Registration Details
- NPI Number
- 1639438435
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 14, 2012 (14.297027043457 yrs)
- Last Updated
- May 14, 2012
- License
-
0002615765-0001-5 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4533 VAN NUYS BLVD STE 302SHERMAN OAKS, CA, 914032950Browse CA providers · Browse ZIP 91403
- Phone
- 8188496755
- Primary Specialty
-
Sports Medicine (IM)
207RS0012X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.