=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154719011
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CATHERINE A. JONES, MD MEDICAL CORP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/30/2014
-----------------------------------------------------
Last Update Date | 12/30/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1190 W OLIVE AVE STE F
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95348-1960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-756-6707
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1190 W OLIVE AVE STE F
-----------------------------------------------------
City | MERCED
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95348-1960
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 209-756-6707
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. CATHERINE A. JONES
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 209-756-6707
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | A110842
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------