MEDICARE: DR. JASON NICHOLAS WON PT, DPT, CSCS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	43044	CA

General Provider Information

NPI Number	:	1356710487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON NICHOLAS WON PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	280 MOFFITT ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-2646
Country	:	US
Telephone Number	:	415-971-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 BATTERY ST FL 3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94111-5543
Country	:	US
Telephone Number	:	415-971-0303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2015
Last Update Date	:	09/18/2015

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