MEDICARE: MICHAEL JONES M.D.

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	207V00000X	Obstetrics & Gynecology Physician	C41770	CA

General Provider Information

NPI Number	:	1760410468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JONES M.D.

Provider Business Mailing Address
First Line	:	709 PASEO DEL MAR
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-1222
Country	:	US
Telephone Number	:	408-918-2600
Fax Number	:	408-795-1129

Provider Business Practice Location Address
First Line	:	709 PASEO DEL MAR
Second Line	:
City	:	PALOS VERDES ESTATES
State	:	CA
Zip	:	90274-1222
Country	:	US
Telephone Number	:	408-918-2600
Fax Number	:	408-795-1129

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	03/27/2012

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