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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

JONATHAN D BOTTS, MD
4955 VAN NUYS BLVD
SUITE 615
SHERMAN OAKS, CA91403-1801
 Phone: 818-905-2222
 Fax: 818-905-8702
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for JONATHAN D BOTTS · (Male)

NPI Number 1457506347
Credentials MD
Entity Individual
Enumeration date 11/19/2008
Last updated 08/02/2012 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
CA License # A 117042
CA Medicare NSC 0368280001
CA Medicare NSC 0368280002
CA Medicare PIN W11945
CA Medicare PIN W11945A
CA Other DA0572 RAILROAD
Hospital affiliation(s)
  • PALMDALE REGIONAL MEDICAL CENTER - (Acute Care)
    38600 MEDICAL CENTER DRIVE
    PALMDALE, CA 93552
  • SHERMAN OAKS HOSPITAL - (Acute Care)
    4929 VAN NUYS BLVD
    SHERMAN OAKS, CA 91403
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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