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General NPI Number Information
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NPI Number | 1790712412
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Entity Type | Individual
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Provider Name | JEFFREY DALE RAWNSLEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 924 WESTWOOD BLVD SUITE 515
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City | LOS ANGELES
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State | CA
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Zip | 90024-2910
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Country | US
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Telephone | 310-570-0244
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Fax |
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Provider Business Mailing Address
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Address Line | 547 CHAPALA DR
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-4430
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Country | US
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Telephone | 310-459-9966
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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 | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number | G78843
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License Number State | CA
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