MEDICARE: JONATHAN MEDICAL INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1679465652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN MEDICAL INC

Provider Business Mailing Address
First Line	:	8797 BEVERLY BLVD STE 350
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1829
Country	:	US
Telephone Number	:	424-302-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	8797 BEVERLY BLVD STE 350
Second Line	:
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-1829
Country	:	US
Telephone Number	:	424-302-0005
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JOSHUA LEWIS
Credential	:	MD
Telephone Number	:	424-302-0005

Provider Enumeration Date	:	07/16/2025
Last Update Date	:	07/16/2025

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