Individual
DR. JEFFREY BOB VIRGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3244
(310) 698-7040
Mailing address
2374 E PACIFICA PL, RANCHO DOMINGUEZ, CA 90220-6214
(310) 225-3244
(310) 698-7040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
MD00028232
WA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
G156025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659460897
—
CA
Enumeration date
10/12/2006
Last updated
09/09/2021
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