Individual
JONATHAN DAVID ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(800) 926-8273
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A161127
CA
207L00000X
Anesthesiology Physician
MD197963
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/29/2015
Last updated
05/17/2023
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