Individual
DR. JONATHAN CARL BIXBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301092684
MI
208000000X
Pediatrics Physician
Primary
A127136
CA
2080S0010X
Pediatric Sports Medicine Physician
A127136
CA
208100000X
Physical Medicine & Rehabilitation Physician
4301092684
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301092684
STATE LISCENCE
MI
01
—
A127136
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
08/19/2008
Last updated
07/10/2018
Update your record
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