Healthcare Provider Details

I. General information

NPI: 1154366011
Provider Name (Legal Business Name): JEFFREY A DRAYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40663 MURRIETA HOT SPRINGS RD STE C3
MURRIETA CA
92562-9015
US

IV. Provider business mailing address

2409 ARTESIA BLVD FL 2
REDONDO BEACH CA
90278-3207
US

V. Phone/Fax

Practice location:
  • Phone: 951-677-5341
  • Fax: 951-387-8004
Mailing address:
  • Phone: 424-276-4700
  • Fax: 424-903-1099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number69506
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: