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Individual

JASVANT N MODI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
711 N ALVARADO ST, SUITE 112, LOS ANGELES, CA 90026-4076
(213) 999-7011
(213) 483-0047
Mailing address
711 N ALVARADO ST, SUITE 112, LOS ANGELES, CA 90026-4076
(213) 999-7011
(213) 483-0047

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
A39818
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A398180
CA
05
00A398181
CA
01
1518046432
NPI
CA
Enumeration date
11/02/2006
Last updated
12/04/2007
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