Individual
JACK WESLEY MORROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
10833 LE CONTE AVE, LOS ANGELES, CA 90095-3075
(310) 319-1234
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA16293
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0PA162930
—
CA
Enumeration date
03/01/2007
Last updated
04/04/2011
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