Provider Demographics
NPI:1467980854
Name:WARNELO, JONATHAN S (DO)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:S
Last Name:WARNELO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 2989
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-1989
Mailing Address - Country:US
Mailing Address - Phone:714-537-7800
Mailing Address - Fax:714-537-7633
Practice Address - Street 1:12665 GARDEN GROVE BLVD
Practice Address - Street 2:#502
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-1904
Practice Address - Country:US
Practice Address - Phone:714-537-7800
Practice Address - Fax:714-537-7633
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A16595208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist