Provider Demographics
NPI:1205075843
Name:UDKOFF, JANE R (MD)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:R
Last Name:UDKOFF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANE
Other - Middle Name:
Other - Last Name:SPARER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1265 CANYON RIM CIR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-5228
Mailing Address - Country:US
Mailing Address - Phone:818-865-1963
Mailing Address - Fax:818-865-9767
Practice Address - Street 1:1265 CANYON RIM CIR
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-5228
Practice Address - Country:US
Practice Address - Phone:818-865-1963
Practice Address - Fax:818-865-9767
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36794207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology