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Organization
PHILLIP JORGE MD INC
Active
Organization
PHILLIP JORGE MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIP JORGE M.D. (DIRECT OWNER)
(818) 888-7815
Entity
Organization
Contact information
Practice address
3828 DELMAS TER, CULVER CITY, CA 90232-2713
(310) 836-7000
(818) 715-1722
Mailing address
PO BOX 7001, TARZANA, CA 91357-7001
(818) 888-7815
(818) 715-1722
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G78921
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
G78921
CA
Other
Enumeration date
03/29/2006
Last updated
09/22/2009
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