Healthcare Provider Details

I. General information

NPI: 1679131189
Provider Name (Legal Business Name): JONATHAN FRANK MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 07/21/2023
Certification Date: 07/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9201 W SUNSET BLVD STE 401
WEST HOLLYWOOD CA
90069-3705
US

IV. Provider business mailing address

9201 W SUNSET BLVD STE 401
WEST HOLLYWOOD CA
90069-3705
US

V. Phone/Fax

Practice location:
  • Phone: 310-622-4764
  • Fax: 310-622-4765
Mailing address:
  • Phone: 310-622-4764
  • Fax: 310-622-4765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP1100X
TaxonomyPodiatric Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JONATHAN FRANK
Title or Position: MEDICAL DIRECTOR / OWNER
Credential: MD
Phone: 310-968-6576