Healthcare Provider Details

I. General information

NPI: 1144939323
Provider Name (Legal Business Name): JASON CHRISTOPHER HULING PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/16/2022
Last Update Date: 11/16/2022
Certification Date: 11/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EVANS HALL
LOMA LINDA CA
92350-0001
US

IV. Provider business mailing address

EVANS HALL
LOMA LINDA CA
92350-0001
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-4599
  • Fax:
Mailing address:
  • Phone: 909-558-4599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: