MEDICARE: DR. JON W PROPST MD

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
1	207L00000X	Anesthesiology Physician	G66978	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1427044494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JON W PROPST MD

Provider Business Mailing Address
First Line	:	937 E MAIN ST
Second Line	:	SUITE 201
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-5323
Country	:	US
Telephone Number	:	805-922-1739
Fax Number	:	805-922-4197

Provider Business Practice Location Address
First Line	:	1400 E CHURCH ST
Second Line	:
City	:	SANTA MARIA
State	:	CA
Zip	:	93454-5906
Country	:	US
Telephone Number	:	805-739-3700
Fax Number	:	805-739-3060

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	07/20/2020

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