Individual provider · NPI-1

Jonathan Brick, D.O.

Family Medicine · La Mesa, CA

NPI number1033596168
StatusActive
Last updated in NPPESNov 2, 2021

Details

NPI
1033596168
Entity type
Individual (NPI-1)
Name
Jonathan Brick
Credential
D.O.
Sex
Male
Sole proprietor
Yes
Enumeration date
Apr 27, 2015
Certification date
Nov 2, 2021
Last updated
Nov 2, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine20A15087CAYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

8080 Parkway Dr
La Mesa, CA 91942

Phone 619-528-5000

Mailing address

11234 Anderson St
Gme Office Westerly Suite C
Loma Linda, CA 92350-1716

Other practice locations

11234 Anderson St
Gme Office Westerly Suite C
Loma Linda, CA 92350-1716

Phone 909-558-6688

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Family Medicine providers in La Mesa, CA