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General NPI Number Information
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NPI Number | 1538482567
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Entity Type | Organization
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Legal Business Name | IRINA JASPER MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 03/04/2010
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Last Update Date | 01/25/2018
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Provider Practice Location Address
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Address Line | 960 E GREEN ST STE 286
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City | PASADENA
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State | CA
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Zip | 91106-2420
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Country | US
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Telephone | 626-356-0340
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Fax | 626-356-0390
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Provider Business Mailing Address
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Address Line | 960 E GREEN ST STE 286
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City | PASADENA
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State | CA
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Zip | 91106-2420
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Country | US
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Telephone | 626-356-0340
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Fax | 626-356-0390
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | PATRICIA GALLEGOS
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Credential |
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Telephone | 626-356-0340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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