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General NPI Number Information
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NPI Number | 1619083979
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Entity Type | Individual
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Provider Name | REGINALD J JONES MD
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Gender | Male
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 05/07/2015
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Provider Practice Location Address
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Address Line | 3737 MARTIN LUTHER KING JR BLVD SUITE 404
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City | LYNWOOD
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State | CA
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Zip | 90262-3513
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Country | US
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Telephone | 424-213-4290
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Fax | 424-213-4295
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Provider Business Mailing Address
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Address Line | 3737 MARTIN LUTHER KING JR BLVD SUITE 404
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City | LYNWOOD
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State | CA
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Zip | 90262-3513
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Country | US
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Telephone | 424-213-4290
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Fax | 424-213-4295
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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 | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | A63406
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | A63406
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A63406
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License Number State | CA
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