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Individual

NORMAN JESSE KACHUCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1520 SAN PABLO ST, SUITE 3000, LOS ANGELES, CA 90033-5310
(323) 442-5710
(323) 442-5729
Mailing address
FILE #57454, LOS ANGELES, CA 90074-0001
(323) 442-5710
(323) 442-5729

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G63328
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G633280
CA
Enumeration date
06/10/2006
Last updated
09/13/2007
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