Provider Demographics
NPI:1306683081
Name:JABLON, MICHAEL (RMST)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:JABLON
Suffix:
Gender:M
Credentials:RMST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2945 TOWNSGATE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-5866
Mailing Address - Country:US
Mailing Address - Phone:714-330-1838
Mailing Address - Fax:
Practice Address - Street 1:8500 WILSHIRE BLVD STE 1018
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3108
Practice Address - Country:US
Practice Address - Phone:949-361-3284
Practice Address - Fax:310-861-1334
Is Sole Proprietor?:No
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAASJ4185210002085U0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound