Provider Demographics
NPI:1922598523
Name:MANN & JONES MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:MANN & JONES MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:TYESHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:562-817-5602
Mailing Address - Street 1:1703 TERMINO AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2128
Mailing Address - Country:US
Mailing Address - Phone:562-817-5602
Mailing Address - Fax:562-817-5605
Practice Address - Street 1:1703 TERMINO AVE STE 207
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2128
Practice Address - Country:US
Practice Address - Phone:562-817-5602
Practice Address - Fax:562-817-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty