Provider Demographics
NPI:1013156520
Name:JANICE L. HULL, M.D., INC.
Entity Type:Organization
Organization Name:JANICE L. HULL, M.D., INC.
Other - Org Name:JANICE L. HULL, M.D.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-778-7990
Mailing Address - Street 1:PO BOX 2116
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-0116
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8475 S VAN NESS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305-1562
Practice Address - Country:US
Practice Address - Phone:323-778-7990
Practice Address - Fax:323-778-2486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-08
Last Update Date:2009-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80999207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A809990Medicaid
CA00A809990Medicaid