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General NPI Number Information
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NPI Number | 1689036592
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Entity Type | Organization
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Legal Business Name | KRISTINE TATOSYAN-JONES MD INC
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Dates
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Enumeration Date | 03/22/2016
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Last Update Date | 03/22/2016
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Provider Practice Location Address
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Address Line | 1108 FREMONT AVE
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City | S PASADENA
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State | CA
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Zip | 91030-3227
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Country | US
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Telephone | 818-209-2148
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Fax |
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Provider Business Mailing Address
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Address Line | 315 N IVY AVE
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City | MONROVIA
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State | CA
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Zip | 91016-2223
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Country | US
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Telephone | 818-209-2148
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Fax |
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | DR. KRISTINE TATOSYAN-JONES
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Credential | M.D.
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Telephone | 818-209-2148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A107807
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License Number State | CA
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