Provider Demographics
NPI:1871639823
Name:AUTH, JONATHAN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:PAUL
Last Name:AUTH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:23961 CALLE DE LA MAGDALENA
Mailing Address - Street 2:SUITE 334
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-3616
Mailing Address - Country:US
Mailing Address - Phone:949-951-5437
Mailing Address - Fax:949-951-2715
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:SUITE 334
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-951-5437
Practice Address - Fax:949-951-2715
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2010-05-25
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Provider Licenses
StateLicense IDTaxonomies
CAA93816208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A938160Medicaid
CA00A938160Medicaid