Individual
MR. JONAS FORTIN OBISPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1250 16TH ST # C2304, SANTA MONICA, CA 90404-1249
(310) 319-4698
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
(310) 301-8707
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95015686
CA
Other
Enumeration date
03/16/2021
Last updated
10/02/2025
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