Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jonathan D Fonbuena, PA-C

Individual provider Medical Physician Assistant · NPI 1093278244

Jonathan D Fonbuena, PA-C is a Medical Physician Assistant in Las Vegas, Nevada. Licensed in Nevada and Utah. Registered with an NPI since 2019.

Licensed in
NV, UT
In the registry since
2019
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1799 Mount Mariah Dr
Las Vegas, NV 89106-1501
Phone: (702) 383-1961
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA2984 (NV)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 13111023-1206 (UT)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1093278244
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 12, 2019
Last updated in NPPESMay 16, 2024
Certification dateMay 16, 2024

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