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NPI Code Detail

MEDICARE: DAVID P JUICE M.D.

MEDICARE:   DAVID P JUICE  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
12085R0202XDiagnostic Radiology PhysicianA129038CA

General Provider Information

NPI Number : 1952637019
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID P JUICE M.D.
Provider Business Mailing Address
First Line : 757 WESTWOOD PLZ
Second Line : DEPARTMENT OF RADIOLOGICAL SCIENCES, ROOM 1621
City : LOS ANGELES
State : CA
Zip : 90095-8358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 757 WESTWOOD PLZ
Second Line : DEPARTMENT OF RADIOLOGICAL SCIENCES, ROOM 1621
City : LOS ANGELES
State : CA
Zip : 90095-8358
Country : US
Telephone Number : 310-267-8758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2009
Last Update Date : 10/30/2015

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Directions to “ DAVID P JUICE M.D.” Practice Location

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