Provider Demographics
NPI:1013043678
Name:RAYMOND, JENNIFER KATHLEEN (MD, MCR)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KATHLEEN
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:MD, MCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3701 WILSHIRE BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2814
Mailing Address - Country:US
Mailing Address - Phone:323-361-3550
Mailing Address - Fax:
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027
Practice Address - Country:US
Practice Address - Phone:888-631-2452
Practice Address - Fax:323-361-8988
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1448252080P0205X
WY8954A2080P0205X
ORMD284612080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology