Provider Demographics
NPI:1669482303
Name:OSTRIKER, JEFFERY ADAM (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFERY
Middle Name:ADAM
Last Name:OSTRIKER
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 4269
Mailing Address - Street 2:
Mailing Address - City:PALOS VERDES ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-9577
Mailing Address - Country:US
Mailing Address - Phone:310-328-3421
Mailing Address - Fax:310-328-3429
Practice Address - Street 1:2406 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-2401
Practice Address - Country:US
Practice Address - Phone:310-328-3421
Practice Address - Fax:310-328-3429
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG48181207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB03078032OtherDEA
CAA92795Medicare UPIN
CAB03078032OtherDEA