Individual
JESSE ELDON THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #214, LOS ANGELES, CA 90095
(310) 825-6078
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
(310) 306-6294
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G27578
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G27578B
MEDICAL PPIN #
CA
Enumeration date
07/25/2006
Last updated
04/12/2011
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