Healthcare Provider Details

I. General information

NPI: 1629012372
Provider Name (Legal Business Name): JEFFREY M. PASKIL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13222 BLOOMFIELD AVE
NORWALK CA
90650
US

IV. Provider business mailing address

PO BOX 25033
SANTA ANA CA
92799-5033
US

V. Phone/Fax

Practice location:
  • Phone: 562-293-3200
  • Fax:
Mailing address:
  • Phone: 714-347-1000
  • Fax: 714-647-1243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG76742
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: