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Organization
JOHN J. DOHERTY, M.D., PH.D., INC.
Active
Organization
JOHN J. DOHERTY, M.D., PH.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J. DOHERTY M.D., PH.D. (PRESIDENT / CEO)
(310) 540-5566
Entity
Organization
Contact information
Practice address
21350 HAWTHORNE BLVD, SUITE 258, TORRANCE, CA 90503-5605
(310) 540-5566
(310) 540-8577
Mailing address
21350 HAWTHORNE BLVD, SUITE 258, TORRANCE, CA 90503-5605
(310) 540-5566
(310) 540-8577
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A22240
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5897216
—
CA
Enumeration date
06/21/2010
Last updated
06/21/2010
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