Provider Demographics
NPI:1427044494
Name:PROPST, JON W (MD)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:W
Last Name:PROPST
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:937 E MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5323
Mailing Address - Country:US
Mailing Address - Phone:805-922-1739
Mailing Address - Fax:805-922-4197
Practice Address - Street 1:1400 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5906
Practice Address - Country:US
Practice Address - Phone:805-739-3700
Practice Address - Fax:805-739-3060
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2020-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG66978207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G669780Medicaid
CAWG66978AMedicare PIN
CA00G669780Medicaid