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:
Health care specialties
| Specialty | Code | License # | 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 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1689649469 | NPPES |
| California | MEDICAID | 00G689030 |
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