Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | A135025 | CA |
Y | 207XS0117X | Orthopaedic Spine Surgeon | A135025 | CA |
NPI | 1285959106 |
---|---|
Provider Name | Dr. Jonathan Joseph Falakassa |
First Address | Van Nuys, CA 91405-3796 |
Second Address | Van Nuys, CA 91405-3796 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2010 |
Last Update Date | 27/07/2016 |