Provider Demographics
NPI:1841248820
Name:HULL, JANICE L (MD)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:L
Last Name:HULL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:L
Other - Last Name:HULL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD, INC
Mailing Address - Street 1:PO BOX 2116
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90305-0116
Mailing Address - Country:US
Mailing Address - Phone:323-778-7990
Mailing Address - Fax:323-778-2486
Practice Address - Street 1:8475 S VAN NESS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90305
Practice Address - Country:US
Practice Address - Phone:323-778-7990
Practice Address - Fax:323-778-2486
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-04
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80999207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A809990Medicaid
CAH78068Medicare UPIN
CA00A809990Medicaid