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General NPI Number Information
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NPI Number | 1447537709
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Entity Type | Organization
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Legal Business Name | JAY JURKOWITZ, M.D. INC.
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD #1000
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City | ENCINO
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State | CA
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Zip | 91436
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Country | US
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Telephone | 818-461-8150
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Fax | 818-461-8157
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BLVD #1000
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City | ENCINO
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State | CA
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Zip | 91436
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Country | US
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Telephone | 818-461-8150
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Fax | 818-461-8157
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Authorized Official
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Title or Position | BUSINESS OWNER
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Name | JAY JURKOWITZ
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Credential | MD
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Telephone | 310-710-4687
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G21741
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License Number State | CA
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