# JONATHAN LEE MINOR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609195452
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080S0010X | Pediatric Sports Medicine Physician | A137057 | CA | Yes |
| 208D00000X | General Practice Physician | 2020036607 | MO | — |

## Other

- **Enumeration date:** 05/19/2010
- **Last updated:** 03/30/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CB238713 | MEDICARE PTAN | CA |