Individual
MR. CORNELL JEFFERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6201 W 87TH ST # 2681, LOS ANGELES, CA 90045-3901
(818) 963-0079
Mailing address
6201 W 87TH ST # 2681, LOS ANGELES, CA 90045-3901
(818) 963-0079
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
8BDF553
CA
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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