Provider Demographics
NPI:1568265387
Name:JONATHAN H. KOENIG, MD - PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JONATHAN H. KOENIG, MD - PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHOPAEDIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:HARLEY
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-828-5441
Mailing Address - Street 1:11710 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-1503
Mailing Address - Country:US
Mailing Address - Phone:310-828-5441
Mailing Address - Fax:424-832-1452
Practice Address - Street 1:11710 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1503
Practice Address - Country:US
Practice Address - Phone:310-828-5441
Practice Address - Fax:424-832-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty