Individual
MR. JASON KENNETH AGUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
136 BRIDGE ST, SAN GABRIEL, CA 91775-2720
(562) 833-0184
Mailing address
136 BRIDGE ST, SAN GABRIEL, CA 91775-2720
(562) 833-0184
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA20040
CA
Other
Enumeration date
12/15/2008
Last updated
05/05/2023
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