Provider Demographics
NPI:1154366011
Name:DRAYER, JEFFREY A (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:DRAYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2409 ARTESIA BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3207
Mailing Address - Country:US
Mailing Address - Phone:424-276-4700
Mailing Address - Fax:424-903-1099
Practice Address - Street 1:40663 MURRIETA HOT SPRINGS RD STE C3
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-9015
Practice Address - Country:US
Practice Address - Phone:951-677-5341
Practice Address - Fax:951-387-8004
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69506207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA69506OtherCALIFORNIA MEDICAL LICENSE
CA69506OtherCALIFORNIA MEDICAL LICENSE
00A695060Medicare PIN