Individual
JASON J PRYSTOWSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 825-2111
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5631
(310) 301-8708
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A99035
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A990350
—
CA
Enumeration date
07/11/2006
Last updated
05/17/2011
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