Provider Demographics
NPI:1558313049
Name:BRASLOW, JONATHAN STEELE (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:STEELE
Last Name:BRASLOW
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:81719 DR CARREON BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92201-5518
Mailing Address - Country:US
Mailing Address - Phone:760-775-8884
Mailing Address - Fax:760-775-8854
Practice Address - Street 1:81719 DR CARREON BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92201-5518
Practice Address - Country:US
Practice Address - Phone:760-775-8884
Practice Address - Fax:760-775-8854
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA26108207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A261080Medicare ID - Type Unspecified
CAD23917Medicare UPIN