Organization
SNL MEDICAL CENTER A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL K JEFFERSON MD (OWNER /CEO)
(818) 616-4484
Entity
Organization
Contact information
Practice address
7400 VAN NUYS BLVD STE 111, VAN NUYS, CA 91405-1972
(818) 616-4484
(818) 616-4494
Mailing address
7400 VAN NUYS BLVD STE 111, VAN NUYS, CA 91405-1972
(818) 616-6484
(818) 616-4494
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G68903
MEDICAL BOARD
CA
Enumeration date
06/10/2022
Last updated
06/10/2022
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