Roddick, Jason L

Roddick, Jason L is an individual health care provider with primary practice located at 25815 Barton Rd Ste 101 , Loma Linda CA 92354-3894. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Roddick, Jason L can be contacted via phone (909) 796-0224.

Contact Information

Primary practice address
25815 Barton Rd Ste 101 Loma Linda CA 92354-3894
Phone: (909) 796-0224
Fax: (909) 796-0225
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA18638 California
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA18638 California

Profile Details

NPI number 1164509899
LBN Legal business name Roddick, Jason L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 1st, 2006
Last updated Dec 9th, 2020 - about 5 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 1164509899 NPPES
Other AR447Z INDIVIDUAL PTAN

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