| Jefferson West Medical Group | |
|
4212 Overland Ave Culver City CA 90230-3736 | |
| (310) 204-2574 | |
| (310) 204-2820 |
| Full Name | Jefferson West Medical Group |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 4212 Overland Ave, Culver City, California |
| Authorized Official Name and Position | Barbara Donahue (PRESIDENT) |
| Authorized Official Contact | 3102042574 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson West Medical Group 4212 Overland Ave Culver City CA 90230-3736 Ph: (310) 204-2574 | Jefferson West Medical Group 4212 Overland Ave Culver City CA 90230-3736 Ph: (310) 204-2574 |
| NPI Number | 1023275542 |
|---|---|
| Provider Enumeration Date | 05/21/2008 |
| Last Update Date | 05/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023275542 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A35973 (California) | Primary |
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