Purdy, Jack Charles

Purdy, Jack Charles is an sole proprietor health care provider with primary practice located at 17337 Tramonto Dr Unit 210, Pacific Palisades CA 90272-3121. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Purdy, Jack Charles can be contacted via phone (310) 453-3533.

Contact Information

Primary practice address
17337 Tramonto Dr Unit 210 Pacific Palisades CA 90272-3121
Phone: (310) 453-3533
Fax: (310) 828-8038
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 00G313870 California

Profile Details

NPI number 1801872155
LBN Legal business name Purdy, Jack Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2005
Last updated Aug 25th, 2014 - about 10 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 1801872155 NPPES
California MEDICAID 27526938

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