Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | A50873 | CA |
NPI | 1245221373 |
---|---|
Provider Name | Dr. Clement Kevin Jones |
First Address | San Francisco, CA 94109 |
Second Address | San Francisco, CA 94109 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2005 |
Last Update Date | 05/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A50873 | CA LICENSE # (01) | CA |
BJ2859520 | DEA (01) | CA |
E92328 | (02) | CA |