Individual
MR. IVAN JESUS PALACIOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA- C
Contact information
Practice address
1975 4TH ST, SAN FRANCISCO, CA 94143-2351
(415) 476-3501
Mailing address
1109 E 5TH ST APT 1422, AUSTIN, TX 78702-3989
(830) 613-5621
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA14405
TX
363AS0400X
Surgical Physician Assistant
Primary
PA66810
CA
Other
Enumeration date
03/03/2020
Last updated
07/24/2025
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