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Individual
REUBEN JONSON
Active
Individual
REUBEN JONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265520183
—
CA
05
—
1306922554
—
CA
05
—
1841342318
—
CA
Enumeration date
08/22/2007
Last updated
11/20/2007
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