Prince, Jonathan Andrew

Prince, Jonathan Andrew is an sole proprietor health care provider with primary practice located at 18321 Clark St , Tarzana CA 91356-3501. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Prince, Jonathan Andrew can be contacted via phone (818) 708-5170.

Contact Information

Primary practice address
18321 Clark St Tarzana CA 91356-3501
Phone: (818) 708-5170
Fax: (818) 705-2595
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A90191 California

Profile Details

NPI number 1003830118
LBN Legal business name Prince, Jonathan Andrew
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 26th, 2006
Last updated Jun 28th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003830118 NPPES
California MEDICAID 00A901910

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