Individual
GARY A. JAEGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25825 VERMONT AVE, HARBOR CITY, CA 90710-3518
(310) 325-5111
Mailing address
393 E WALNUT ST, 3RD FLOOR PHR SYSTEMS, PASADENA, CA 91188-0001
(000) 000-0000
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
G27251
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G272510
—
CA
Enumeration date
11/13/2006
Last updated
11/29/2007
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