MEDICARE: JASMINE S UITZ

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	363A00000X	Physician Assistant	Y5608378	CA

General Provider Information

NPI Number	:	1063369544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASMINE S UITZ

Provider Business Mailing Address
First Line	:	325 W OLYMPIC LN
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-5271
Country	:	US
Telephone Number	:	562-552-4733
Fax Number	:

Provider Business Practice Location Address
First Line	:	325 W OLYMPIC LN
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-5271
Country	:	US
Telephone Number	:	562-552-4733
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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Directions to “ JASMINE S UITZ ” Practice Location

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