Individual
MR. JAKE WATSON JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
11301 WILSHIRE BLVD, LOS ANGELES, CA 90073-1003
(310) 478-3711
Mailing address
3731 S NORTON AVE, LOS ANGELES, CA 90018-4046
(323) 296-2388
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
14184
CA
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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