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General NPI Number Information
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NPI Number | 1205093895
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Entity Type | Individual
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Provider Name | DR. KRISTOFER JASON JONES
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Gender | Male
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 08/01/2013
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Provider Practice Location Address
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Address Line | 10833 LE CONTE AVE 76-143 CHS
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City | LOS ANGELES
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State | CA
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Zip | 90095-6902
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Country | US
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Telephone | 212-203-8234
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Fax |
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Provider Business Mailing Address
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Address Line | 11789 MONTANA AVE #15
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City | LOS ANGELES
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State | CA
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Zip | 90049-6711
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | A126262
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License Number State | CA
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