Healthcare Provider Details
I. General information
NPI: 1477813384
Provider Name (Legal Business Name): JONATHAN KALMAN N.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/24/2012
Last Update Date: 04/02/2024
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3252 HOLIDAY CT STE 204
LA JOLLA CA
92037-1808
US
IV. Provider business mailing address
5694 MISSION CENTER RD STE 602-328
SAN DIEGO CA
92108-4355
US
V. Phone/Fax
- Phone: 619-777-6567
- Fax: 619-243-7395
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | ND9 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 175F00000X |
| Taxonomy | Naturopath |
| License Number | ND-9 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: