Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | A143138 | CA |
NPI | 1083927503 |
---|---|
Provider Name | Dr. Jonathan Aaron Praeger |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2010 |
Last Update Date | 11/09/2020 |