Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 134449 | CA |
NPI | 1215235858 |
---|---|
Provider Name | Jhanvi Menon |
First Address | San Marcos, CA 92078-4201 |
Second Address | San Marcos, CA 92078-4201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2011 |
Last Update Date | 29/11/2021 |