Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC11393 | CA |
NPI | 1497826077 |
---|---|
Provider Name | Dr. Jayson Ivan Sher |
First Address | Los Angeles, CA 90049-2114 |
Second Address | Los Angeles, CA 90025-4650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |