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General NPI Number Information
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NPI Number | 1184975948
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Entity Type | Organization
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Legal Business Name | 1.JILL FURGURSON, M.D., INC.
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 23656 PACIFIC COAST HWY
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City | MALIBU
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State | CA
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Zip | 90265-4800
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Country | US
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Telephone | 310-456-7551
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Fax |
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Provider Business Mailing Address
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Address Line | 23941 DE VILLE WAY
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City | MALIBU
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State | CA
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Zip | 90265-4894
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Country | US
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Telephone | 818-710-7761
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JILL E. FURGURSON
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Credential | M.D.
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Telephone | 818-710-7761
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | G36815
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License Number State | CA
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