Provider Demographics
NPI:1548295926
Name:JONES, LESTER JOSEPH JR (DPM)
Entity type:Individual
Prefix:DR
First Name:LESTER
Middle Name:JOSEPH
Last Name:JONES
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:14445 OLIVE VIEW DR
Mailing Address - Street 2:2B156 DEPT OF SUNGONY
Mailing Address - City:SYLMAL
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-364-3194
Mailing Address - Fax:
Practice Address - Street 1:1260 15TH STREET
Practice Address - Street 2:SUITE 1260
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404
Practice Address - Country:US
Practice Address - Phone:310-451-1618
Practice Address - Fax:310-395-6797
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAE1836213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T11069Medicare UPIN