Individual
RICHARD LESTER STEPHEN JENNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1441 EASTLAKE AVE, LOS ANGELES, CA 90089-0112
(323) 865-3050
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 865-3050
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G87183
CA
Other
Enumeration date
03/21/2007
Last updated
11/27/2023
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