Provider Demographics
NPI:1083608004
Name:SEMEL, JANE ALISON (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ALISON
Last Name:SEMEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 N PACIFIC COAST HWY
Mailing Address - Street 2:STE 1100
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4476
Mailing Address - Country:US
Mailing Address - Phone:310-641-1700
Mailing Address - Fax:310-695-7413
Practice Address - Street 1:390 N SEPULVEDA BLVD
Practice Address - Street 2:SUITE 1100
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4475
Practice Address - Country:US
Practice Address - Phone:310-641-1700
Practice Address - Fax:310-695-7413
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2018-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60663174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G606630Medicaid
CAWG60663KMedicare ID - Type Unspecified
F35487Medicare UPIN