Healthcare Provider Details

I. General information

NPI: 1639734551
Provider Name (Legal Business Name): JEFFREY HOLLANDER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2019
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15031 RINALDI ST
MISSION HILLS CA
91345-1207
US

IV. Provider business mailing address

11333 SEPULVEDA BLVD
MISSION HILLS CA
91345-1116
US

V. Phone/Fax

Practice location:
  • Phone: 818-365-8051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A19400
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: