Provider Demographics
NPI:1174580328
Name:EASTHOPE, JOHN L JR (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:L
Last Name:EASTHOPE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:55 E CALIFORNIA BLVD
Mailing Address - Street 2:3RD FL
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3944
Mailing Address - Country:US
Mailing Address - Phone:626-793-1227
Mailing Address - Fax:626-793-3794
Practice Address - Street 1:55 E CALIFORNIA BLVD
Practice Address - Street 2:3RD FL
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3944
Practice Address - Country:US
Practice Address - Phone:626-793-1227
Practice Address - Fax:626-793-3794
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2011-11-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA25402207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25402OtherBLUE SHIELD
CA060336921OtherRAIL ROAD MEDICARE
CA060336921OtherRAIL ROAD MEDICARE
CAA25402OtherBLUE SHIELD