MR. JASON WAGNER (NPI# 1457753519) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457753519 |
| Entity Type | Individual |
| Full Name | MR. JASON WAGNER |
| Credential | PA-C |
| Practice Address |
2025 E Route 66 Glendora CA 91740-4670 |
| Mailing Address |
984 W Foothill Blvd Upland CA 91786-3700 |
| Practice Telephone | 6263354610 |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2019-04-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 51951 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053700765 | Jason Robert Wagner | Counselor | 8728 S 120 E, Sandy, UT 84070-1526 | 2015-01-19 |
| 1821427287 | Jason Leigh Wagner | Counselor | 505 5th St., Suite 520, Sioux City, IA 51101 | 2013-11-06 |
| 1376003517 | Jason Wagner | Student in an Organized Health Care Education/Training Program | 6431 Fannin St # 1.150, Houston, TX 77030-1501 | 2019-03-22 |
| 1720536691 | Jason Fredrick Wagner | Counselor | 6075 Bathey Ln, Naples, FL 34116-7536 | 2016-09-20 |
| 1215329420 | Jason Wagner | Counselor | 2405 28th St, Anacortes, WA 98221-2484 | 2015-02-25 |
| 1902168925 | Jason Kane Wagner | Surgery | 600 N Cattlemen Rd Ste 220, Sarasota, FL 34232-6422 | 2012-06-14 |
| 1093014334 | Jason Wagner | Counselor | 360 Whiskey Hill Rd, Watsonville, CA 95076-8521 | 2011-03-25 |
| 1588729768 | Jason E Wagner | Internal Medicine | 3400 Civic Center Blvd, West Pavilion 1st Fl, Philadelphia, PA 19104-5127 | 2006-12-27 |
| 1689641961 | Jason C Wagner | Emergency Medicine | 400 S Kingshighway Blvd, Saint Louis, MO 63110-1014 | 2006-03-05 |
| 1972594471 | Jason Michael Wagner | Radiology | 940 Ne 13th St, Suite 4g4250, Oklahoma City, OK 73104-5008 | 2005-11-03 |
| Street Address |
2025 E ROUTE 66 |
| City | GLENDORA |
| State | CA |
| Zip Code | 91740-4670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407821275 | Jovi Cacnio | Pediatrics | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-02-22 |
| 1992237325 | Michelle Lautfy Zaki | Internal Medicine | 2025 E Route 66, Glendora, CA 91740-4670 | 2017-04-03 |
| 1992237143 | Marina Atef Nemetalla | Student in an Organized Health Care Education/Training Program | 2025 E Route 66, Glendora, CA 91740-4670 | 2017-03-28 |
| 1780070318 | Ha Tran | Family Medicine | 2025 E Route 66, Glendora, CA 91740-4670 | 2015-04-10 |
| 1043352362 | Health Care Partners, Inc. | Non-Pharmacy Dispensing Site | 2025 E Route 66, Glendora, CA 91740-4670 | 2007-02-13 |
| 1750474557 | Virginia Lynn Barrett | Internal Medicine | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-10-02 |
| 1144312505 | Lisa H Kimpark | Pediatrics | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-09-29 |
| 1649370487 | Cathryn Johanna Wechsler | Pediatrics | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-09-22 |
| 1306942545 | Wail Akram Shoga | Internal Medicine | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-09-15 |
| 1619070539 | Nalini Singh | Internal Medicine | 2025 E Route 66, Glendora, CA 91740-4670 | 2006-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215559638 | Kenny Tokuji Michioka | Nurse Practitioner | 1208 S Barranca Ave Unit C, Glendora, CA 91740 | 2020-05-07 |
| 1629535380 | Sudario Home Health Care, Inc. | Home Health | 620 W Riute 66 Suite 220a, Glendora, CA 91740 | 2019-02-28 |
| 1659872711 | Matthew Christian Mendoza | Counselor | 1160 S Grand Avenue, Glendora, CA 91740 | 2018-02-23 |
| 1972029981 | Keyauna C Thomas | Case Manager/Care Coordinator | 987 Shady Lane, Glendora, CA 91740 | 2017-08-21 |
| 1356891055 | Stephanie L Contreras | Counselor | 2200 E Route 66 Ste 200, Glendora, CA 91740 | 2016-10-06 |
| 1912454547 | Natalie Sayegh | Dentist | 102 W. Route 66, Suite G, Glendora, CA 91740 | 2016-09-01 |
| 1255715744 | Daily Care,llc | Non-emergency Medical Transport (VAN) | 623 Lemar Park Drive, B, Glendora, CA 91740 | 2015-07-14 |
| 1245661776 | Rjdj Hospice Care, Inc. | Hospice Care, Community Based | 631 E. Arrow Hwy Ste E, Glendora, CA 91740 | 2013-12-10 |
| 1285061168 | Nam Dao | Nurse Practitioner | 1377 S. Grand Ave, Glendora, CA 91740 | 2013-10-09 |
| 1508292384 | Keaunna Sonae Knox | Speech-Language Pathologist | 420 E. Baseline St Suite D & E, Glendora, CA 91740 | 2013-09-24 |
| Find all providers in zip 91740 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205461100 | Tiana Abouchedid | Physician Assistant | 1130 Kregmont Dr, Glendora, CA 91741-2249 | 2020-03-11 |
| 1720456726 | Acacia Sutherland | Physician Assistant | 543 W Leeside St, Glendora, CA 91741-4230 | 2015-09-08 |
| 1154491074 | Deina Inman Stewart | Physician Assistant | 1365 S. Grand Avenue, Glendora, CA 91740 | 2006-11-08 |
| 1922035948 | David Y Kim | Physician Assistant | 1365 S Grand Ave, Glendora, CA 91740-5047 | 2006-06-26 |
| 1841648573 | Robert Cory Zapotosky | Physician Assistant | 210 S Grand Ave, Glendora, CA 91741-4205 | 2016-06-03 |
| 1134590342 | Honeycomb Medical Services, A Med Corp | Physician Assistant | 250 S Grand Ave, Glendora, CA 91741-4218 | 2015-10-14 |
| 1346635372 | Candace Hope Mcfarlin | Physician Assistant | 2301 E Foothill Blvd, Suite 100, Glendora, CA 91740-4000 | 2015-04-06 |
| 1346672680 | Amanda E Duncan | Physician Assistant | 2301 E Foothill Blvd, Glendora, CA 91740-4000 | 2013-08-08 |
| 1275886715 | Ashlene Janiece Korcek | Physician Assistant | 2301 E Foothill Blvd, Suite 100, Glendora, CA 91740-4000 | 2012-10-22 |
| 1326349960 | David Abovian | Physician Assistant | 1365 S Grand Ave, Glendora, CA 91740-5047 | 2010-11-13 |
| Find all providers in GLENDORA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.