Individual
JORGE GONZALO JARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
200 MERCY CIRCLE, CAMP PENDLETON, CA 92055
(760) 719-3308
Mailing address
PO BOX 555191, CAMP PENDLETON, CA 92055-5191
(760) 719-3308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
0110005612
VA
Other
Enumeration date
04/30/2015
Last updated
08/23/2022
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