MEDICARE: JEFFREY S MARGOLIS 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	207X00000X	Orthopaedic Surgery Physician	230508	MA

General Provider Information

NPI Number	:	1881767192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY S MARGOLIS M.D.

Provider Business Mailing Address
First Line	:	372 MONTEREY RD
Second Line	:	APARTMENT #5
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-3579
Country	:	US
Telephone Number	:	323-226-7210
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N STATE ST
Second Line	:	ROOM 3900
City	:	LOS ANGELES
State	:	CA
Zip	:	90089-1001
Country	:	US
Telephone Number	:	323-226-7210
Fax Number	:

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	12/13/2021

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