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General NPI Number Information
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NPI Number | 1366474868
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Entity Type | Organization
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Legal Business Name | RICHARD B. JURMAIN MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 07/09/2010
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Provider Practice Location Address
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Address Line | 9808 VENICE BLVD SUITE 503
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City | CULVER CITY
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State | CA
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Zip | 90232-2732
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Country | US
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Telephone | 310-815-1650
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Fax |
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Provider Business Mailing Address
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Address Line | 9808 VENICE BLVD SUITE 503
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City | CULVER CITY
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State | CA
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Zip | 90232-2732
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Country | US
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Telephone | 310-815-1650
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | RICHARD B JURMAIN
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Credential | M.D.
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Telephone | 310-815-1650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | A22905
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License Number State | CA
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