Individual
JAY EDWARD PERSSELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 268-3633
(310) 268-4250
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 825-6301
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G44398
CA
207RR0500X
Rheumatology Physician
Primary
G44398
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G443980
—
CA
Enumeration date
07/27/2006
Last updated
07/19/2010
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