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Individual

DR. THEODORE JAMES JEKUMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1801 W ROMNEYA DR, 404, ANAHEIM, CA 92801-1830
(714) 535-4747
(714) 535-4054
Mailing address
1801 W ROMNEYA DR, 404, ANAHEIM, CA 92801-1830
(714) 535-4747
(714) 535-4054

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G23626
CA
208C00000X
Colon & Rectal Surgery Physician
G23626
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G236261
CA
Enumeration date
04/04/2006
Last updated
01/28/2015
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