Provider Demographics
NPI:1770858201
Name:ALTON, JAY DONALD (AA, RASI)
Entity Type:Individual
Prefix:MR
First Name:JAY
Middle Name:DONALD
Last Name:ALTON
Suffix:
Gender:M
Credentials:AA, RASI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1638 KIRKWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94124-2137
Mailing Address - Country:US
Mailing Address - Phone:415-671-1165
Mailing Address - Fax:415-970-0438
Practice Address - Street 1:1638 KIRKWOOD AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94124-2137
Practice Address - Country:US
Practice Address - Phone:415-671-1165
Practice Address - Fax:415-970-0438
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-16
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program