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General NPI Number Information
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NPI Number | 1679711204
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Entity Type | Individual
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Provider Name | JENNIFER MADRIGAL PA
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Gender | Female
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Dates
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Enumeration Date | 02/04/2009
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Last Update Date | 02/04/2009
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Provider Practice Location Address
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Address Line | 2675 W OLYMPIC BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90006-2880
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Country | US
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Telephone | 213-383-9955
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Fax |
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Provider Business Mailing Address
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Address Line | 1117 BUNBURY DR
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City | WHITTIER
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State | CA
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Zip | 90601-1212
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Country | US
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Telephone | 213-383-9955
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA20065
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License Number State | CA
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