Jon A Detterich
Pediatric Emergency Physician
4650 W Sunset Blvd Ms #113
Los Angeles
, California 90027-6062
Jon A Detterich
Pediatric Emergency Physician
4650 W Sunset Blvd Ms #113
Los Angeles
, California 90027-6062
(323) 361-8491
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About
Features
Specialties
- Pediatric Emergency Physician
Languages spoken
- English
Location
First Address
- Jon A Detterich
- 6430 W Sunset Blvd Suite 600
- Los Angeles, CA
- Zip : 90028-7901
- Fax : (323) 361-8491
- Phone : (232) 361-2337
Second Address
- Jon A Detterich
- 4650 W Sunset Blvd Ms #113
- Los Angeles, CA
- Zip : 90027-6062
- Phone : (323) 361-2109
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PP0204X | Pediatric Emergency Physician | A89834 | CA |
National Provider Identifier
| NPI | 1659518884 |
|---|---|
| Provider Name | Jon A Detterich |
| First Address | Los Angeles, CA 90028-7901 |
| Second Address | Los Angeles, CA 90027-6062 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 09/01/2009 |
| Last Update Date | 09/01/2009 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.