Jefferson, Michael

Jefferson, Michael is an individual health care provider with primary practice located at 1509 Wilson Terrace , Glendale CA 91206-4098. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Anesthesiology is his primary health care specialty. Jefferson, Michael can be contacted via phone (818) 409-8000.

Contact Information

Primary practice address
1509 Wilson Terrace Glendale CA 91206-4098
Phone: (818) 409-8000
Fax: (818) 546-5632
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X G68903 California
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X G68903 California

Profile Details

NPI number 1689649469
LBN Legal business name Jefferson, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Nov 30th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689649469 NPPES
California MEDICAID 00G689030

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