Provider Demographics
NPI:1740681717
Name:OH, JESSIE (PA)
Entity type:Individual
Prefix:
First Name:JESSIE
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:707 S GARFIELD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-5859
Mailing Address - Country:US
Mailing Address - Phone:626-282-1600
Mailing Address - Fax:626-656-1264
Practice Address - Street 1:707 S GARFIELD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ALHAMBRA
Practice Address - State:CA
Practice Address - Zip Code:91801-5859
Practice Address - Country:US
Practice Address - Phone:626-282-1600
Practice Address - Fax:626-656-1264
Is Sole Proprietor?:No
Enumeration Date:2014-09-10
Last Update Date:2023-01-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA51855363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant