Doctor Name: | JONATHAN PAUL MAN |
NPI Number: | 1255619789 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MT200414 |
Business Practice Address: | 2851 S Avenue B Bldg 20 Yuma, AZ - 853647726 |
Business Phone Number: | 9283362434 |
Business Fax Number: | 9283362435 |
Mailing Address: | 2581 @ Avenue B Building 20, YUMA |
State: | AZ |
Postal Code: | 853647726 |
Phone Number: | 9283362434 |
Fax Number: | 9283362435 |
NPI Enumeration Date: | 08/02/2011 |
NPI Last Update Date: | 07/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | MT200414 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |