Provider Demographics
NPI:1477608040
Name:APPLEGATE, JASON M (CRNA)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:M
Last Name:APPLEGATE
Suffix:
Gender:M
Credentials:CRNA
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Mailing Address - Street 1:8440 FOUNTAIN AVE APT 302
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-2567
Mailing Address - Country:US
Mailing Address - Phone:424-666-9752
Mailing Address - Fax:
Practice Address - Street 1:450 N ROXBURY DR STE 600
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4225
Practice Address - Country:US
Practice Address - Phone:310-651-2050
Practice Address - Fax:310-651-2055
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2022-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CANA4329367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered