Provider Demographics
NPI:1578727889
Name:FOX, JONATHAN C (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:C
Last Name:FOX
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1788 CLAY ST
Mailing Address - Street 2:STE 809
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3613
Mailing Address - Country:US
Mailing Address - Phone:610-864-3190
Mailing Address - Fax:
Practice Address - Street 1:400 EAST JAMIE COURT
Practice Address - Street 2:MYOKARDIA, INC., STE 102
Practice Address - City:SOUTH SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94080
Practice Address - Country:US
Practice Address - Phone:650-741-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-049591-L207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease