Provider Demographics
NPI:1083135065
Name:JEFFREY JUMAILY MD INC
Entity Type:Organization
Organization Name:JEFFREY JUMAILY MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:S
Authorized Official - Last Name:JUMAILY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-285-9612
Mailing Address - Street 1:8816 BURTON WAY # 1
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-1715
Mailing Address - Country:US
Mailing Address - Phone:310-285-9612
Mailing Address - Fax:310-285-9615
Practice Address - Street 1:8816 BURTON WAY # 1
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1715
Practice Address - Country:US
Practice Address - Phone:310-285-9612
Practice Address - Fax:310-285-9615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA147007207Y00000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Multi-Specialty