Boutros, Jason K

Boutros, Jason K is an individual health care provider with primary practice located at 2554 E Washington Blvd Ste A, Pasadena CA 91107-1445. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Boutros, Jason K can be contacted via phone (626) 798-8923.

Contact Information

Primary practice address
2554 E Washington Blvd Ste A Pasadena CA 91107-1445
Phone: (626) 798-8923
Fax: (626) 798-0258
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X A42891 California

Profile Details

NPI number 1942243563
LBN Legal business name Boutros, Jason K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Feb 2nd, 2017 - about 8 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 1942243563 NPPES
California MEDICAID 00A42891
California Other A42891

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