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General NPI Number Information
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NPI Number | 1831494954
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Entity Type | Organization
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Legal Business Name | J L NAVARRETE M D INC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/21/2011
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Provider Practice Location Address
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Address Line | 3231 E GAGE AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-5441
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Country | US
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Telephone | 323-582-8240
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Fax | 323-582-8022
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Provider Business Mailing Address
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Address Line | 300 1/2 GARFIELD AVE
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City | S PASADENA
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State | CA
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Zip | 91030-2267
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Country | US
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Telephone | 323-582-8240
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Fax | 323-582-8022
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JORGE NAVARRETE
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Credential | M.D.
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Telephone | 323-582-8240
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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 | A78571
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License Number State | CA
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