Individual
JUAN CARLOS JIMENEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 UCLA MEDICAL PLZ STE 526, LOS ANGELES, CA 90095-0001
(310) 206-6294
(310) 794-9603
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
A75166
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A751660
—
CA
Enumeration date
06/04/2006
Last updated
12/20/2019
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