Individual
JESSICA SIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8700 BEVERLY BLVD # B220, WEST HOLLYWOOD, CA 90048-1804
(310) 423-5252
(310) 423-8441
Mailing address
4140 W 190TH ST, TORRANCE, CA 90504-5513
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A161511
CA
208M00000X
Hospitalist Physician
Primary
A161511
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2017
Last updated
06/16/2022
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