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General NPI Number Information
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NPI Number | 1922156843
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Entity Type | Individual
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Provider Name | JONATHAN CARP MD
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 13652 CANTARA ST
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City | PANORAMA CITY
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State | CA
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Zip | 91402-5423
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Country | US
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Telephone | 818-375-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 2845 PGA BLVD
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City | PALM BEACH GARDENS
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State | FL
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Zip | 33410-2910
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Country | US
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Telephone | 818-375-2000
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A71841
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License Number State | CA
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