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Organization
CAMILO S JORGE M.D. PROF CORP
Active
Organization
CAMILO S JORGE M.D. PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD S JORGE M.D. (PRESIDENT/OWNER)
(562) 531-1946
Entity
Organization
Contact information
Practice address
16415 COLORADO AVE, SUITE 102, PARAMOUNT, CA 90723-5035
(562) 531-1946
(562) 531-1010
Mailing address
16415 COLORADO AVE, SUITE 102, PARAMOUNT, CA 90723-5035
(562) 531-1946
(562) 531-1010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A18393
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A183931
—
CA
01
—
1215028238
NPI
CA
Enumeration date
01/21/2010
Last updated
08/04/2021
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