Provider Demographics
NPI:1255458626
Name:JONES AND BELLAH MDS
Entity type:Organization
Organization Name:JONES AND BELLAH MDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:LINN
Authorized Official - Last Name:BELLAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-725-9383
Mailing Address - Street 1:3304 RENNER DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORTUNA
Mailing Address - State:CA
Mailing Address - Zip Code:95540
Mailing Address - Country:US
Mailing Address - Phone:707-725-9383
Mailing Address - Fax:707-725-1140
Practice Address - Street 1:3304 RENNER DR
Practice Address - Street 2:
Practice Address - City:FORTUNA
Practice Address - State:CA
Practice Address - Zip Code:95540-3120
Practice Address - Country:US
Practice Address - Phone:707-725-9383
Practice Address - Fax:707-725-1140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAYYY50013YMedicare PIN