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Individual

DR. JONATHAN TODD ENGELHARDT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 GRANT RD, MOUNTAIN VIEW, CA 94040
(650) 940-7000
Mailing address
2100 POWELL ST STE 400, EMERYVILLE, CA 94608-1826
(510) 350-2600

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
32462
AZ
207P00000X
Emergency Medicine Physician
Primary
A89837
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
39-81220
EVERCARE GROUP
AZ
01
453051001
GROUP HEALTH GROUP
AZ
01
86-0373636
HUMANA GROUP
AZ
05
884016
AZ
01
AW1436
HEALTHNET GROUP
AZ
01
AZ0728670
BLUECROSS/BLUESHIELD GRP
AZ
Enumeration date
11/07/2005
Last updated
09/30/2019
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