MEDICARE: JASON OH PHARM.D.

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	183500000X	Pharmacist	70387	CA

General Provider Information

NPI Number	:	1245603018
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON OH PHARM.D.

Provider Business Mailing Address
First Line	:	800 PALM AVE
Second Line	:
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1529
Country	:	US
Telephone Number	:	619-424-8989
Fax Number	:	619-424-9614

Provider Business Practice Location Address
First Line	:	800 PALM AVE
Second Line	:
City	:	IMPERIAL BEACH
State	:	CA
Zip	:	91932-1529
Country	:	US
Telephone Number	:	619-424-8989
Fax Number	:	619-424-9614

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

Provider Enumeration Date	:	11/02/2015
Last Update Date	:	11/05/2022

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Directions to “ JASON OH PHARM.D.” Practice Location

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