Jimenez, Andres

Jimenez, Andres is an individual health care provider with primary practice located at 1294 W 6Th St Suite 103, San Pedro CA 90731-2987. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Jimenez, Andres can be contacted via phone (310) 831-9482.

Contact Information

Primary practice address
1294 W 6Th St Suite 103 San Pedro CA 90731-2987
Phone: (310) 831-9482
Fax: (310) 831-1230
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X G55250 California

Profile Details

NPI number 1871609404
LBN Legal business name Jimenez, Andres
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 23rd, 2006
Last updated Apr 15th, 2021 - about 5 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 1871609404 NPPES
California MEDICAID 00G552500

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