Healthcare Provider Details
I. General information
NPI: 1891376562
Provider Name (Legal Business Name): MADISON ELIZABETH JONES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/15/2021
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1975 ZONAL AVE
LOS ANGELES CA
90089-5601
US
IV. Provider business mailing address
1975 ZONAL AVE
LOS ANGELES CA
90089-5601
US
V. Phone/Fax
- Phone: 323-442-1100
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207N00000X |
| Taxonomy | Dermatology Physician |
| License Number | A188805 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: