Individual
JESSICA D FAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
981 W FOOTHILL BLVD, CLAREMONT, CA 91711-3304
(909) 667-7769
Mailing address
981 W FOOTHILL BLVD, CLAREMONT, CA 91711-3304
(909) 667-7769
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA53780
CA
Other
Enumeration date
09/27/2016
Last updated
10/11/2023
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