Basic Information
| Provider Information | |||||||||
| NPI: | 1639355449 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUBSCHMAN | ||||||||
| FirstName: | JEAN-PIERRE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5767 WEST CENTURY BLVD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900455655 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108255000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 100 STEIN PLAZA | ||||||||
| Address2: | RM. 1-340 | ||||||||
| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900957065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3108255000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2008 | ||||||||
| LastUpdateDate: | 06/22/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | F5457 | CA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 00F54570 | 05 | CA | MEDICAID |