Individual
DR. ETHEL DIJAMCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6511 VAN NUYS BLVD, VAN NUYS, CA 91401-1425
(818) 901-9090
(818) 901-9347
Mailing address
PO BOX 10432, BEVERLY HILLS, CA 90213-3432
(213) 637-2530
(213) 384-3373
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A48307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A483070
—
CA
Enumeration date
11/28/2006
Last updated
07/09/2007
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