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Organization

JASON K BOUTROS M D INC

Active
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Organization

JASON K BOUTROS M D INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CINDY CHON (ADMINISTRATOR)
(626) 798-8923
Entity
Organization

Contact information

Practice address
2750 E WASHINGTON BLVD, SUITE 260, PASADENA, CA 91107-1448
(626) 798-8923
(626) 798-0258
Mailing address
2750 E WASHINGTON BLVD, SUITE 260, PASADENA, CA 91107-1448
(626) 798-8923
(626) 798-0258

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A42891
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0076360
—
CA
Enumeration date
05/01/2007
Last updated
01/28/2011
About Stedi
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