Chiaki Miura Jutabha, MD | |
2501 N Sepulveda Blvd Ste 101, Manhattan Beach, CA 90266-2722 | |
(310) 546-8702 | |
(310) 545-5310 |
Full Name | Chiaki Miura Jutabha |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 2501 N Sepulveda Blvd Ste 101, Manhattan Beach, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760493126 | NPI | - | NPPES |
00A648330 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | A64833 (California) | Primary |
Entity Name | Uc Regents |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1982667663 PECOS PAC ID: 4587568829 Enrollment ID: O20031119001005 |
Mailing Address | Practice Location Address |
---|---|
Chiaki Miura Jutabha, MD 5767 W Century Blvd, Suite 200, Los Angeles, CA 90045-5632 Ph: (310) 829-9935 | Chiaki Miura Jutabha, MD 2501 N Sepulveda Blvd Ste 101, Manhattan Beach, CA 90266-2722 Ph: (310) 546-8702 |
Joanna May Wong, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 855 Manhattan Beach Blvd, Ste 103, Manhattan Beach, CA 90266 Phone: 310-939-7850 Fax: 310-939-7851 | |
Vivian Yi Lin, Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 N Sepulveda Blvd Ste 190, Manhattan Beach, CA 90266 Phone: 310-546-8702 Fax: 310-545-5310 | |
Dr. Sandra Kathleen Smith-lang, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 578 31st St, Manhattan Beach, CA 90266 Phone: 310-890-6209 Fax: 310-546-2955 | |
Christine Kao, D.O. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1000 N Sepulveda Blvd Ste 190, Manhattan Beach, CA 90266 Phone: 310-546-8702 | |
Mahsa Madani, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 855 Manhattan Beach Blvd, Manhattan Beach, CA 90266 Phone: 281-610-3848 | |
Casey Sherman, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2501 N Sepulveda Blvd, Suite 101, Manhattan Beach, CA 90266 Phone: 310-546-8702 | |
Dr. Keith Robin Bayan, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1000 N Sepulveda Blvd Ste 190, Manhattan Beach, CA 90266 Phone: 310-546-8702 Fax: 310-545-5310 |