MEDICARE: DR. JEFFREY MICHAEL EGLER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A87469	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366420523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY MICHAEL EGLER M.D.

Provider Business Mailing Address
First Line	:	2811 WILSHIRE BLVD
Second Line	:	SUITE 610
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4803
Country	:	US
Telephone Number	:	310-453-2335
Fax Number	:	214-393-4645

Provider Business Practice Location Address
First Line	:	2811 WILSHIRE BLVD
Second Line	:	SUITE 610
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-4803
Country	:	US
Telephone Number	:	310-453-2335
Fax Number	:	214-393-4645

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	04/29/2015

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Directions to “ DR. JEFFREY MICHAEL EGLER M.D.” Practice Location

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