Provider Demographics
NPI:1609905033
Name:STRAWN, JON BRADLEY (MD, MS, MBA)
Entity Type:Individual
Prefix:DR
First Name:JON
Middle Name:BRADLEY
Last Name:STRAWN
Suffix:
Gender:M
Credentials:MD, MS, MBA
Other - Prefix:DR
Other - First Name:BRAD
Other - Middle Name:
Other - Last Name:STRAWN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1401 AVOCADO AVE
Mailing Address - Street 2:SUITE 501
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7720
Mailing Address - Country:US
Mailing Address - Phone:949-706-8273
Mailing Address - Fax:949-706-8274
Practice Address - Street 1:1401 AVOCADO AVE
Practice Address - Street 2:SUITE 501
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-7720
Practice Address - Country:US
Practice Address - Phone:949-706-8273
Practice Address - Fax:949-706-8274
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA97411208200000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery