Individual
MR. JONATHAN DELOSSANTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
2152 S VINEYARD STE 131, MESA, AZ 85210
(480) 788-8539
(844) 538-9355
Mailing address
2152 S VINEYARD STE 131, MESA, AZ 85210-6882
(480) 788-8539
(844) 538-9355
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5881
AZ
Other
Enumeration date
11/06/2014
Last updated
06/25/2019
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