Individual
DR. JONATHAN ANDREW PRINCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18321 CLARK ST, TARZANA, CA 91356-3501
(818) 708-5170
(818) 705-2595
Mailing address
PO BOX 660640, ARCADIA, CA 91066-0640
(626) 447-0296
(626) 447-6057
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A90191
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A901910
—
CA
Enumeration date
07/26/2006
Last updated
06/28/2012
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