Individual
JESSE ANN SOODALTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1520 SAN PABLO ST STE 1000, LOS ANGELES, CA 90033-5312
(323) 442-5100
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-5100
Taxonomy
Speciality
Code
Description
License number
State
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
83281
GA
207R00000X
Internal Medicine Physician
83281
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
83281
GA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
C196957
CA
Other
Enumeration date
07/07/2009
Last updated
09/04/2024
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