Individual
DR. JONATHAN E TRAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MADRONE ST, WILLITS, CA 95490-4225
(707) 456-3093
(707) 256-3508
Mailing address
PO BOX 3222, NAPA, CA 94558-0293
(707) 261-7822
(707) 256-3508
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G68878
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G688780
—
CA
Enumeration date
07/27/2006
Last updated
04/10/2012
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