MEDICARE: DR. JONATHAN MARK SYKES M.D., F.A.C.S.

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	207Y00000X	Otolaryngology Physician	G59454	CA

General Provider Information

NPI Number	:	1851377493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JONATHAN MARK SYKES M.D., F.A.C.S.

Provider Business Mailing Address
First Line	:	8975 CAMINO DEL AVION
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-5858
Country	:	US
Telephone Number	:	916-652-5417
Fax Number	:	916-456-7509

Provider Business Practice Location Address
First Line	:	8975 CAMINO DEL AVION
Second Line	:
City	:	GRANITE BAY
State	:	CA
Zip	:	95746-5858
Country	:	US
Telephone Number	:	916-652-5417
Fax Number	:	916-456-7509

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

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	09/28/2016

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