Organization
JIMMY L EZELL MEDICAL CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JIMMY L EZELL M.D (PRESIDENT)
(323) 971-2250
Entity
Organization
Contact information
Practice address
7500 S WESTERN AVE, LOS ANGELES, CA 90047-2429
(323) 971-2250
(323) 971-5605
Mailing address
7500 S WESTERN AVE, LOS ANGELES, CA 90047-2429
(323) 971-2250
(323) 971-5605
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
C27187
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C271870
—
CA
Enumeration date
02/20/2009
Last updated
03/06/2009
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