Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 288979 | NY |
Y | 207W00000X | Ophthalmologist | A170239 | CA |
NPI | 1023441052 |
---|---|
Provider Name | Dr. Bryan Paul Jones |
First Address | Culver City, CA 90230-5138 |
Second Address | Pasadena, CA 91107-5522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2013 |
Last Update Date | 10/05/2021 |