Individual
JON A DETTERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, MS #113, LOS ANGELES, CA 90027-6062
(323) 361-2109
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(232) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
A89834
CA
Other
Enumeration date
01/09/2009
Last updated
01/09/2009
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