Provider Demographics
NPI:1952470486
Name:FARMER, JASON R
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:R
Last Name:FARMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 VIA RONDA
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069
Mailing Address - Country:US
Mailing Address - Phone:760-807-3249
Mailing Address - Fax:
Practice Address - Street 1:550 WEST VISTA WAY
Practice Address - Street 2:SUITE 407
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083
Practice Address - Country:US
Practice Address - Phone:760-758-1092
Practice Address - Fax:760-758-8481
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program