Provider Demographics
NPI:1275822363
Name:JOHNS, JASON ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:ROBERT
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2070 MENZEL PL
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-3652
Mailing Address - Country:US
Mailing Address - Phone:480-694-8523
Mailing Address - Fax:
Practice Address - Street 1:300 PASTEUR DRIVE, H3580
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-5640
Practice Address - Country:US
Practice Address - Phone:650-723-7377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122257207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology