Virgin, Jeffrey Bob

Virgin, Jeffrey Bob is an sole proprietor health care provider with primary practice located at 2374 E Pacifica Pl , Rancho Dominguez CA 90220-6214. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Virgin, Jeffrey Bob can be contacted via phone (310) 225-3244.

Contact Information

Primary practice address
2374 E Pacifica Pl Rancho Dominguez CA 90220-6214
Phone: (310) 225-3244
Fax: (310) 698-7040
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X MD00028232 Washington
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X G156025 California

Profile Details

NPI number 1659460897
LBN Legal business name Virgin, Jeffrey Bob
Credentials M.D., PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Sep 9th, 2021 - about 4 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 1659460897 NPPES
California MEDICAID 1659460897

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