Hendrix, Theodric Blue

Hendrix, Theodric Blue is an sole proprietor health care provider with primary practice located at 450 N Roxbury Dr Suite 500, Beverly Hills CA 90210-4231. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Obstetrics is his primary health care specialty. Hendrix, Theodric Blue can be contacted via phone (310) 652-3570.

Contact Information

Primary practice address
450 N Roxbury Dr Suite 500 Beverly Hills CA 90210-4231
Phone: (310) 652-3570
Fax: (310) 388-0157
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A29978 California
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X A29978 California

Profile Details

NPI number 1528138294
LBN Legal business name Hendrix, Theodric Blue
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2006
Last updated Sep 13th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528138294 NPPES
California Other 00A299780 BLUE SHIELD PROVIDER #

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