Individual
CLEMENT JERRY KOVAR II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3330 LOMITA BLVD, TORRANCE, CA 90505-5002
(310) 325-9110
(310) 784-8762
Mailing address
PO BOX 60790, PASADENA, CA 91116-6790
(626) 795-6596
(626) 396-0851
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G25022
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G250220
BLUE SHIELD
CA
05
—
00G250220
—
CA
Enumeration date
07/24/2006
Last updated
02/03/2011
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