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General NPI Number Information
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NPI Number | 1033614920
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Entity Type | Individual
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Provider Name | JEFFREY TOMOYA FUJIMOTO MD
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Gender | Male
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Dates
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Enumeration Date | 03/24/2018
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Last Update Date | 08/27/2024
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Provider Practice Location Address
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Address Line | 2020 SANTA MONICA BLVD STE 210
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City | SANTA MONICA
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State | CA
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Zip | 90404-2139
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Country | US
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Telephone | 310-458-2381
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Fax |
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Provider Business Mailing Address
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Address Line | 5767 W CENTURY BLVD STE 400
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City | LOS ANGELES
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State | CA
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Zip | 90045-5631
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Country | US
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Telephone | 310-301-8707
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A164274
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License Number State | CA
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