Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | G-40090 | CA |
N | 208600000X | Surgeon | G-40090 | CA |
N | 2082S0105X | Plastic Hand Surgeon | G-40090 | CA |
N | 2086S0105X | Surgery of the Hand | G40090 | CA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | G-40090 | CA |
NPI | 1609956531 |
---|---|
Provider Name | Jonathan Weymouth Jones |
First Address | San Diego, CA 92103-2116 |
Second Address | San Diego, CA 92103-2116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 23/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G400900 | (05) | CA |
A92158 | (02) | CA |