Provider Demographics
NPI:1326606518
Name:MURRAY, JESSE LEE
Entity Type:Individual
Prefix:
First Name:JESSE
Middle Name:LEE
Last Name:MURRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 WILKERSON AVE STE A-D
Mailing Address - Street 2:
Mailing Address - City:PERRIS
Mailing Address - State:CA
Mailing Address - Zip Code:92570-2200
Mailing Address - Country:US
Mailing Address - Phone:951-345-1193
Mailing Address - Fax:
Practice Address - Street 1:170 WILKERSON AVE STE A-D
Practice Address - Street 2:
Practice Address - City:PERRIS
Practice Address - State:CA
Practice Address - Zip Code:92570-2200
Practice Address - Country:US
Practice Address - Phone:951-345-1193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist