Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | F474 | CA |
NPI | 1235675711 |
---|---|
Provider Name | Dr. Luke Jones |
First Address | Redwood City, CA 94063-3132 |
Second Address | Redwood City, CA 94063-3132 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/01/2017 |
Last Update Date | 27/03/2017 |