Individual
JESSICA LYNN PERNICIARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4650 W SUNSET BLVD, MAILSTOP 113, LOS ANGELES, CA 90027
(323) 361-2109
Mailing address
4650 W SUNSET BLVD, MAILSTOP 113, LOS ANGELES, CA 90027-6062
(323) 361-2109
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
261603
NY
208000000X
Pediatrics Physician
Primary
A135530
CA
208000000X
Pediatrics Physician
D0075578
MD
Other
Enumeration date
06/05/2008
Last updated
09/10/2018
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