Individual
MR. JASON POLHAMUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4885 ROYCE RD, IRIVNE, CA 92612
(949) 735-0822
Mailing address
4885 ROYCE RD, IRVINE, CA 92612-2233
(949) 735-0822
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
CA
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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