Individual
JACK PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15243 VANOWEN ST, SUITE 301, VAN NUYS, CA 91405-3605
(818) 782-5041
(818) 782-4864
Mailing address
15243 VANOWEN ST, SUITE 301, VAN NUYS, CA 91405-3605
(818) 782-5041
(818) 782-4864
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G24768
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G24768
—
CA
Enumeration date
08/30/2005
Last updated
02/10/2010
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