Individual
JONATHAN ENTWISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2452 WATSON CT, PALO ALTO, CA 94303-3216
(650) 723-6995
Mailing address
2452 WATSON CT, PALO ALTO, CA 94303-3216
(650) 723-6995
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
1-107906
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA95000308
CA
Other
Enumeration date
12/04/2013
Last updated
09/14/2015
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