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General NPI Number Information
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NPI Number | 1851476600
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Entity Type | Organization
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Legal Business Name | JOHN J SUMMERS MD, INC
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 1300 N VERMONT AVE 1009
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City | LOS ANGELES
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State | CA
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Zip | 90027-6005
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Country | US
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Telephone | 323-666-6210
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Fax | 323-666-6240
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Provider Business Mailing Address
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Address Line | 1300 N VERMONT AVE 1009
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City | LOS ANGELES
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State | CA
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Zip | 90027-6005
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Country | US
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Telephone | 323-666-6210
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Fax | 323-666-6240
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Authorized Official
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Title or Position | OWNER / MD
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Name | DR. JOHN J SUMMERS
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Credential | M.D.
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Telephone | 323-666-6210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | A17969
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License Number State | CA
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