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Individual

DR. THEODRIC BLUE HENDRIX JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
450 N ROXBURY DR, SUITE 500, BEVERLY HILLS, CA 90210-4231
(310) 652-3570
(310) 388-0157
Mailing address
450 N ROXBURY DR, SUITE 500, BEVERLY HILLS, CA 90210-4231
(310) 652-3570
(310) 388-0157

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
A29978
CA
207VX0000X
Obstetrics Physician
Primary
A29978
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A299780
BLUE SHIELD PROVIDER #
CA
Enumeration date
11/09/2006
Last updated
09/13/2013
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