MR. JON CHARLES LACY (NPI# 1588907638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588907638 |
| Entity Type | Individual |
| Full Name | MR. JON CHARLES LACY |
| Credential | PA |
| Practice Address |
6368 Hollywood Blvd Los Angeles CA 90028-6320 |
| Practice Telephone | 3234695555 |
| Practice Fax Number | 3234660405 |
| Mailing Telephone | 3234695555 |
| Mailing Fax Number | 3234660405 |
| Enumeration Date | 2013-03-27 |
| Last Update Date | 2016-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA22770 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
6368 HOLLYWOOD BLVD |
| City | LOS ANGELES |
| State | CA |
| Zip Code | 90028-6320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902891773 | Astral Pharmacy Inc | Pharmacy | 6368 Hollywood Blvd, Los Angeles, CA 90028-6320 | 2005-09-16 |
| 1477029866 | Amanda Jean Parker | Social Worker | 6368 Hollywood Blvd, Los Angeles, CA 90028-6320 | 2018-10-23 |
| 1932610334 | Gerald Edward Ferg IIi | Nurse Practitioner | 6368 Hollywood Blvd, Los Angeles, CA 90028-6320 | 2017-10-12 |
| 1689042798 | Adrienne Panlilio | Physician Assistant | 6368 Hollywood Blvd, Los Angeles, CA 90028-6320 | 2015-09-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154929859 | Luxottica of America Inc | Eyewear Supplier (Equipment, not the service) | 5500 W Sunset Blvd, Los Angeles, CA 90028 | 2020-10-14 |
| 1558993527 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 5500 West Sunset Boulevard, Los Angeles, CA 90028 | 2020-02-07 |
| 1639715030 | Michelle Jennifer Martinez | Case Manager/Care Coordinator | 6838 Sunset Blvd., Hollywood, CA 90028 | 2019-11-20 |
| 1821562315 | Ronnie Jerome Jackson | Case Manager/Care Coordinator | Bhs Hollywood Recovery Center, 6838 Sunset Blvd, Hollywood, CA 90028 | 2019-01-17 |
| 1669961595 | Danielle Arce | Dietitian, Registered | 6721 De Longpre Ave, Los Angeles, CA 90028 | 2018-05-07 |
| 1982124772 | Yoon Kyung Lee | Pharmacist | 7201 Hollywood Blvd, Los Angeles, CA 90028 | 2017-06-22 |
| 1982133245 | Julia West | Pharmacist | 6201 Hollywood Blvd #126, Los Angeles, CA 90028 | 2017-06-08 |
| 1720527971 | Melissa Susac | Marriage & Family Therapist | 1540 Schrader Blvd, Garden Suite 12, Hollywood, CA 90028 | 2017-02-21 |
| 1023554284 | Arlene Aranda | Social Worker | 1873 Taft Ave, Los Angeles, CA 90028 | 2017-01-12 |
| 1912304775 | Damon Dodge | Marriage & Family Therapist | 7083 Hollywood Blvd, Los Angeles, CA 90028 | 2014-11-21 |
| Find all providers in zip 90028 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386115137 | Sonya Lorain Earley | Physician Assistant | 2020 Zonal Avenue, Ird 626, Los Angeles, CA 90033 | 2018-12-05 |
| 1942738943 | Sophavy Suon | Physician Assistant | 11611 San Vicente Blvd Lbby Level, Los Angeles, CA 90049-5106 | 2017-06-02 |
| 1619429503 | Rachel Frankenthal | Physician Assistant | 200 Medical Plz Ste 220, Ucla Department of Obgyn, Los Angeles, CA 90095-0001 | 2016-10-26 |
| 1982152815 | Accessmed A Physician Assistant Professional Corporation | Physician Assistant | 1055 W 7th St Fl 33, Los Angeles, CA 90017-2577 | 2016-09-20 |
| 1043766363 | Amber Joy Rangel | Physician Assistant | 2523 Armacost Ave, Los Angeles, CA 90064-2715 | 2016-08-28 |
| 1184080459 | Doreen Yasharel | Physician Assistant | 824 S Wooster St Apt 306, Los Angeles, CA 90035-1745 | 2016-01-02 |
| 1649649443 | Thuy Vo | Physician Assistant | 5841 Bowcroft St, Unit 2, Los Angeles, CA 90016-4955 | 2015-09-22 |
| 1649655663 | Carlee Ettinger | Physician Assistant | 2751 Rinconia Dr, Los Angeles, CA 90068-2227 | 2015-07-21 |
| 1841681467 | Lauren Layson | Physician Assistant | 4049 Via Marisol, Los Angeles, CA 90042-5055 | 2015-02-18 |
| 1871981282 | Dianne Desiree Rivera Navoa | Physician Assistant | 8631 W 3rd St Ste 1035e, Los Angeles, CA 90048-5964 | 2015-01-07 |
| Find all providers in LOS ANGELES | ||||
| City | LOS ANGELES |
| Zip Code | 90028 |
Please comment or provide details below to improve the information on MR. JON CHARLES LACY.
| 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.