Individual
DR. JEFFREY PHILIP BOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12555 W JEFFERSON BLVD STE 302, LOS ANGELES, CA 90066-7032
(424) 443-5600
(424) 443-5600
Mailing address
1811 WILSHIRE BLVD STE 110, SANTA MONICA, CA 90403-5626
(310) 453-9010
(310) 828-3661
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G86941
CA
208000000X
Pediatrics Physician
ME66931
FL
Other
Enumeration date
01/31/2007
Last updated
03/29/2021
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