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Objects / Healthcare Organization

Healthcare Organization Stored source record

JOHN J. JOLLEY, M.D. A PROFESSIONAL CORPORATION

750 LAS GALLINAS AVE STE 106, SAN RAFAEL, CA, 949033408

atlas:atm_npi_1053607903

Block 3004Block Group 3Census Tract 1082.02Marin CountyCaliforniaUnited States

What is stored

phone
415-888-2755
status
A
address
750 LAS GALLINAS AVE STE 106, SAN RAFAEL, CA, 949033408
fax
415-888-2754
npi
1053607903
license
G021951
taxonomy
Clinic/Center, Medical Specialty
other names
[]
last updated
2020-04-16
license state
CA
taxonomy code
261QM2500X
all taxonomies
["Clinic/Center, Medical Specialty"]
enumeration date
2011-06-20
enumeration type
NPI-2
practice locations
0
authorized official
JOHN JOLLEY
organizational subpart
NO

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{
  "fax": "415-888-2754",
  "npi": "1053607903",
  "phone": "415-888-2755",
  "status": "A",
  "address": "750 LAS GALLINAS AVE STE 106, SAN RAFAEL, CA, 949033408",
  "license": "G021951",
  "taxonomy": "Clinic/Center, Medical Specialty",
  "other_names": [],
  "last_updated": "2020-04-16",
  "license_state": "CA",
  "taxonomy_code": "261QM2500X",
  "all_taxonomies": [
    "Clinic/Center, Medical Specialty"
  ],
  "enumeration_date": "2011-06-20",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "JOHN JOLLEY",
  "organizational_subpart": "NO"
}