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NPI Code Detail

MEDICARE: JOLIE PFAHLER MD

MEDICARE: JOLIE PFAHLER MD
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
1207P00000XEmergency Medicine PhysicianG80734CA

Other Identifiers

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

General Provider Information

NPI Number : 1629033782
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOLIE PFAHLER MD
Provider Business Mailing Address
First Line : PO BOX 12079
Second Line :
City : WESTMINSTER
State : CA
Zip : 92685
Country : US
Telephone Number : 562-809-3595
Fax Number : 562-468-0347
Provider Business Practice Location Address
First Line : 1328 TWENTY SECOND STREET
Second Line :
City : SANTA MONICA
State : CA
Zip : 90404-2091
Country : US
Telephone Number : 310-582-7089
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2006
Last Update Date : 04/15/2008

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