Individual
DR. ANDRES JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1294 W 6TH ST, SUITE 103, SAN PEDRO, CA 90731-2987
(310) 831-9482
(310) 831-1230
Mailing address
1499 W 1ST ST, SAN PEDRO, CA 90732-3255
(310) 831-9482
(310) 832-0994
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G55250
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G552500
—
CA
Enumeration date
08/23/2006
Last updated
04/15/2021
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