Organization
WALT JAY MEDICAL CORPORATION
Active
Other names
Integrative Industrial & Family Practice Medical Clinics
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERINE GANEGODA III (ASSISTANT TO OFFICE MANAGER)
(213) 483-9902
Entity
Organization
Contact information
Practice address
1930 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90057-3605
(213) 483-9902
(213) 483-5174
Mailing address
1930 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90057-3605
(213) 483-9902
(213) 483-5174
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/31/2008
Last updated
01/31/2008
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