Provider Demographics
NPI:1689974255
Name:JO, MARK JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:JEFFREY
Last Name:JO
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10 CONGRESS ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3045
Mailing Address - Country:US
Mailing Address - Phone:626-795-0282
Mailing Address - Fax:626-792-0682
Practice Address - Street 1:10 CONGRESS ST
Practice Address - Street 2:SUITE 103
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3045
Practice Address - Country:US
Practice Address - Phone:626-795-0282
Practice Address - Fax:626-792-0682
Is Sole Proprietor?:No
Enumeration Date:2010-10-28
Last Update Date:2015-02-18
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Provider Licenses
StateLicense IDTaxonomies
CAA122314207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma