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Individual
JONATHAN LEE MINOR
Active
Individual
JONATHAN LEE MINOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
Primary
A137057
CA
208D00000X
General Practice Physician
2020036607
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB238713
MEDICARE PTAN
CA
Enumeration date
05/19/2010
Last updated
03/30/2026
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