Organization · Type 2 NPI
Jerry Judd Pryde JR MD PC
Clinic/Center · Los Angeles, CA
NPI number
1407396914
Active
Practice location
1130 S Flower St, Unit 412
Los Angeles, CA 90015-2139
Fax (213) 403-4373
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinic/Center Primary | 261Q00000X | A60849 (CA) |
Clinic/Center: A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
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About NPI 1407396914
Jerry Judd Pryde JR MD PC's National Provider Identifier is 1407396914, issued on Mar 2, 2017. The primary taxonomy on file is Clinic/Center (261Q00000X), and the practice location is in Los Angeles, CA. The record was last updated on Mar 2, 2017.