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General NPI Number Information
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NPI Number | 1548391287
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Entity Type | Organization
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Legal Business Name | JOHN K F DEBEIXEDON MD INC
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 675 S ARROYO PKWY STE 320
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City | PASADENA
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State | CA
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Zip | 91105-3264
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Country | US
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Telephone | 626-577-9495
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Fax | 626-792-2117
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Provider Business Mailing Address
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Address Line | PO BOX 90067
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City | PASADENA
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State | CA
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Zip | 91109-5067
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Country | US
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Telephone | 626-577-9495
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Fax | 626-792-2117
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN K F DEBEIXEDON
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Credential |
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Telephone | 626-577-9495
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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 | A46593
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License Number State | CA
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