Provider Demographics
NPI:1700187812
Name:KATO, JASON SHINA (PA)
Entity Type:Individual
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First Name:JASON
Middle Name:SHINA
Last Name:KATO
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Gender:M
Credentials:PA
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Mailing Address - Street 1:6430 W SUNSET BLVD
Mailing Address - Street 2:600
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90028-7900
Mailing Address - Country:US
Mailing Address - Phone:323-361-2337
Mailing Address - Fax:323-361-8491
Practice Address - Street 1:4650 W SUNSET BLVD
Practice Address - Street 2:MS 102
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6062
Practice Address - Country:US
Practice Address - Phone:323-361-2169
Practice Address - Fax:323-361-3101
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-04
Last Update Date:2021-12-01
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Provider Licenses
StateLicense IDTaxonomies
CAPA 21004363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant