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1962430017 NPI number — JASON PATRICK PALMER DO

NPI Number: 1962430017
Health Care Provider/Practitioner: JASON PATRICK PALMER DO

Information about “1962430017” NPI (JASON PATRICK PALMER DO) exists in 1962430017 in HTML format HTML  |  1962430017 in plain Text format TXT  |  1962430017 in PDF (Portable Document Format) PDF  |  1962430017 in an XML format XML  formats.

NPI Number : 1962430017 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962430017",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PALMER",
    "FirstName": "JASON",
    "MiddleName": "PATRICK",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "DO",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "9220 SHIRLEY CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LA MESA",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91941-4266",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "619-762-0104",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3325 SENN RD",
    "SecondLinePracticeLocationAddress": "NAVAL BASE SAN DIEGO BLDG 291",
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92136-0001",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "760-725-1400",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/29/2006",
    "LastUpdateDate": "09/03/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207Q00000X",
        "TaxonomyName": "Family Medicine Physician",
        "LicenseNumber": "9605",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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