Jerry Judd Pryde Jr MD PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A60849 Issued in CA

Legal business name

JERRY JUDD PRYDE JR MD PC

Practice address

1130 S Flower St
Unit 412
Los Angeles, CA 90015-2139

Phone

(310) 423-2182

Fax

(213) 403-4373

NPI assigned

Mar 2, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jerry Judd Pryde Jr., MD

Title

President

Phone

(310) 423-2182

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1407396914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 S FLOWER ST",
            "address_2": "UNIT 412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152139",
            "telephone_number": "310-423-2182",
            "fax_number": "213-403-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 S FLOWER ST",
            "address_2": "UNIT 412",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900152139",
            "telephone_number": "310-423-2182",
            "fax_number": "213-403-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY JUDD PRYDE JR MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "PRYDE",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "JUDD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-423-2182",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A60849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Jeronimo-Mejia
• Jessi Jeronimo
• Ritchie Jeronimo
• Jerrica Kirkley M.D., P.C.
• Jerrold H Steiner MD a Medical Corp
• Jerry Judd Pryde Jr MD PC
• Jerry Judd Pryde Jr., M.D., P.C.
• Jerry L Lanier DDS Inc
• Jerry L Lanier DDS Inc.
• Jerry L Lanier DDS Inc.

• Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.