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General NPI Number Information
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NPI Number | 1134521172
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Entity Type | Organization
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Legal Business Name | DJTL, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 08/30/2015
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Provider Practice Location Address
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Address Line | 600 S SPRING ST PH9
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City | LOS ANGELES
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State | CA
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Zip | 90014-1979
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Country | US
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Telephone | 323-484-6331
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Fax | 877-363-2219
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Provider Business Mailing Address
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Address Line | 600 S SPRING ST PH9
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City | LOS ANGELES
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State | CA
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Zip | 90014-1979
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Country | US
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Telephone | 323-484-6331
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Fax | 877-363-2219
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Authorized Official
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Title or Position | PHYSCIAN
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Name | DR. DANIEL TURNER-LLOVERAS
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Credential | MD
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Telephone | 323-484-6331
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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 | 121387
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License Number State | CA
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