Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 217150 | MA |
N | 208600000X | Surgeon | 217150 | MA |
NPI | 1003872177 |
---|---|
Provider Name | Julie L Jones |
First Address | Redlands, CA 92373-6949 |
Second Address | Redlands, CA 92373-6949 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 16/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H85232 | (02) | MA |