MEDICARE: JONATHAN BLOCH, DO, INC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1467390419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN BLOCH, DO, INC

Provider Business Mailing Address
First Line	:	1026 3RD ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-0543
Country	:	US
Telephone Number	:	303-520-4336
Fax Number	:

Provider Business Practice Location Address
First Line	:	1026 3RD ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-0543
Country	:	US
Telephone Number	:	303-520-4336
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN BLOCH
Credential	:
Telephone Number	:	303-520-4336

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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