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Individual

MR. ROBERT MICHAEL JEFFRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
C.O.

Contact information

Practice address
444 S SAN VICENTE BLVD, MGB, SUITE 603, LOS ANGELES, CA 90048-4165
(310) 313-5874
(310) 395-1187
Mailing address
PO BOX 3698, SANTA MONICA, CA 90408-3698
(310) 313-5874
(310) 395-1187

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
XA0007130
CA
Enumeration date
04/30/2007
Last updated
07/09/2007
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