Provider Demographics
NPI:1861711673
Name:OSBORNE, JONATHAN D (DO)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:D
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:743 SUNRIVER LN
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-0167
Mailing Address - Country:US
Mailing Address - Phone:530-604-8022
Mailing Address - Fax:530-241-1174
Practice Address - Street 1:1755 COURT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1721
Practice Address - Country:US
Practice Address - Phone:530-247-8800
Practice Address - Fax:530-241-1174
Is Sole Proprietor?:No
Enumeration Date:2010-05-19
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A11216207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine