Maddox, Jan Paul

Maddox, Jan Paul is an individual health care provider with primary practice located at 4500 Brockton Ave Ste 305, Riverside CA 92501-4028. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Maddox, Jan Paul can be contacted via phone (951) 715-3963.

Contact Information

Primary practice address
4500 Brockton Ave Ste 305 Riverside CA 92501-4028
Phone: (951) 715-3963
Fax: (951) 715-3960
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Pain Medicine 208VP0014X A26683 California

Profile Details

NPI number 1699770974
LBN Legal business name Maddox, Jan Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2005
Last updated Nov 19th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699770974 NPPES
California Other 00A320460 MEDI-CAL
California Other ZZZ05981Z MEDI-CAL

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