Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 30111 | CA |
NPI | 1154513232 |
---|---|
Provider Name | Dr. Jonathan Janfaza |
First Address | Beverly Hills, CA 90211-1825 |
Second Address | Beverly Hills, CA 90211-1825 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2007 |
Last Update Date | 13/08/2007 |