Provider Demographics
NPI:1043104961
Name:J&P SPINE CENTER INC
Entity type:Organization
Organization Name:J&P SPINE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:GINGER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-294-2657
Mailing Address - Street 1:6079 N FRESNO ST STE 101
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5276
Mailing Address - Country:US
Mailing Address - Phone:818-294-2657
Mailing Address - Fax:
Practice Address - Street 1:457 E ALMOND AVE STE 105
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5764
Practice Address - Country:US
Practice Address - Phone:559-538-3145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:J&P SPINE CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty