Provider Demographics
NPI:1376557439
Name:WEEKS, JONATHAN C (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:C
Last Name:WEEKS
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 1:6077 COFFEE RD
Mailing Address - Street 2:STE4 #55
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308
Mailing Address - Country:US
Mailing Address - Phone:661-369-1410
Mailing Address - Fax:
Practice Address - Street 1:2215 TRUXTUN AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3602
Practice Address - Country:US
Practice Address - Phone:661-632-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA104384207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACM810ZMedicare PIN
CAP00879616Medicare PIN