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General NPI Number Information
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NPI Number | 1417688086
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Entity Type | Organization
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Legal Business Name | JERRICA KIRKLEY M.D., P.C.
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Dates
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Enumeration Date | 06/23/2022
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 633 WEST FIFTH ST. 28TH FLOOR OFFICE 2848
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City | LOS ANGELES
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State | CA
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Zip | 90071
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Country | US
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Telephone | 720-248-4483
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Fax |
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Provider Business Mailing Address
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Address Line | 303 S. BROADWAY #200-357
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City | DENVER
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State | CO
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Zip | 80209
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Country | US
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Telephone | 720-248-4483
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF ACCOUNTING
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Name | CLAIRE WILENSKY
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Credential |
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Telephone | 305-632-3463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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