Provider Demographics
NPI:1205852100
Name:CURRIER, JESSE WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:WILLIAM
Last Name:CURRIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-301-8708
Mailing Address - Fax:310-899-7140
Practice Address - Street 1:200 MEDICAL PLAZA
Practice Address - Street 2:#214,365,530,420,120
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-825-0631
Practice Address - Fax:310-794-2116
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG77590207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G775900OtherMEDI-CAL PPIN#
CA00G775900OtherMEDI-CAL PPIN#
CABR438ZMedicare PIN
CAE01934Medicare UPIN
CAWG77590EMedicare PIN
CAWG77590DMedicare PIN
CAWG77590CMedicare PIN