Provider Demographics
NPI:1063614139
Name:O'NEAL, JON T (MD, MPH)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:T
Last Name:O'NEAL
Suffix:
Gender:M
Credentials:MD, MPH
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:67555 E PALM CANYON DR STE C113
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-5412
Mailing Address - Country:US
Mailing Address - Phone:760-328-5679
Mailing Address - Fax:
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-9272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2023-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-307322083X0100X
CAG836232083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine