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NPI Code Detail

MEDICARE: MARILYN CRANDALL JONES M.D.

MEDICARE: MARILYN CRANDALL JONES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207SG0201XClinical Genetics (M.D.) PhysicianG30850CA
2208000000XPediatrics PhysicianG30850CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295806040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARILYN CRANDALL JONES M.D.
Provider Business Mailing Address
First Line : 3020 CHILDRENS WAY
Second Line : MC5003
City : SAN DIEGO
State : CA
Zip : 92123-4223
Country : US
Telephone Number : 858-309-6300
Fax Number :
Provider Business Practice Location Address
First Line : 7920 FROST ST
Second Line : STE 200
City : SAN DIEGO
State : CA
Zip : 92123-2736
Country : US
Telephone Number : 858-966-5840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2006
Last Update Date : 02/16/2017

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Directions to “ MARILYN CRANDALL JONES M.D.” Practice Location

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