Individual
JASON P CUSTODIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O., M.H.A.
Contact information
Practice address
5426 E OLYMPIC BLVD, COMMERCE, CA 90022-5113
(323) 725-7372
Mailing address
5426 E OLYMPIC BLVD, COMMERCE, CA 90022-5113
(323) 725-7372
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
14035
CA
Other
Enumeration date
01/27/2007
Last updated
03/03/2017
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