Jason Kenneth Agustin (NPI# 1861637274, PAC ID# 0143358705) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1861637274 |
| PAC ID by PECOS | 0143358705 |
| Professional Enrollment ID | I20100503000534 |
| Full Name | Jason Kenneth Agustin |
| Organization Legal Name | ADVANCED LUNG CENTER MEDICAL GROUP INC. |
| Address |
401 S La Brea Ave Inglewood CA 90301-2321 |
| Phone Number | 3102757575 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 4082508197 |
| Number of Group Practice Members | 3 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050135 | SOUTHERN CALIFORNIA HOSPITAL AT HOLLYWOOD |
| 050561 | KAISER FOUNDATION HOSPITAL - WEST LA |
| Address | Phone | Organization |
|---|---|---|
| 401 S La Brea Ave, Inglewood, CA 90301-2321 | 3102757575 | ADVANCED LUNG CENTER MEDICAL GROUP INC. |
| Organization Legal Name | ADVANCED LUNG CENTER MEDICAL GROUP INC. |
| Physicians | 3 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamshid Niknam | Internal Medicine | Advanced Lung Center Medical Group Inc. | 401 S La Brea Ave, Inglewood, CA 90301-2321 |
| Kane John Dominguez Cua | Nurse Practitioner | Advanced Lung Center Medical Group Inc. | 401 S La Brea Ave, Inglewood, CA 90301-2321 |
| Street Address |
401 S LA BREA AVE |
| City | INGLEWOOD |
| State | CA |
| Zip | 90301-2321 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jamshid Niknam | Internal Medicine | Advanced Lung Center Medical Group Inc. | 401 S La Brea Ave, Inglewood, CA 90301-2321 |
| Kane John Dominguez Cua | Nurse Practitioner | Advanced Lung Center Medical Group Inc. | 401 S La Brea Ave, Inglewood, CA 90301-2321 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles Gyden | Physical Therapy | 426 W Manchester Blvd, Inglewood, CA 90301-1110 | |
| Bambi Lynn Nickelberry | Family Medicine | 248 N Locust St, Inglewood, CA 90301-1204 | |
| Carolina B Aguero | Optometry | Scolinos Optometry Inc | 236 N Market St, Inglewood, CA 90301-1217 |
| Mae Lae Louie | Optometry | Scolinos Optometry Inc. | 236 N Market St, Inglewood, CA 90301-1217 |
| Payman Vahedifar | Internal Medicine | 211 N Prairie Ave, Suite A, Inglewood, CA 90301-1412 | |
| Cranford L Scott | Internal Medicine | 233 N Prairie Ave, Inglewood, CA 90301-1412 | |
| Stuart Edwin Strausberg | Diagnostic Radiology | Icm Medical Group Inc | 211 N Prairie Ave, Inglewood, CA 90301-1412 |
| Anitha T Mitchell | Internal Medicine | 211 N Prairie Ave, Inglewood, CA 90301-1412 | |
| James H Peace | Ophthalmology | 431 N Prairie Ave, Inglewood, CA 90301-1413 | |
| Jonathan Tiongson | Podiatry | 455 N Prairie Ave, Inglewood, CA 90301-1413 | |
| Find all physicians in zip 90301 | |||
| City | INGLEWOOD |
| Zip Code | 90301 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | INGLEWOOD + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Jason Kenneth Agustin.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.