MEDICARE: JASON W KNOTT PA

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	363AS0400X	Surgical Physician Assistant	PA15980	CA

General Provider Information

NPI Number	:	1700843059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASON W KNOTT PA

Provider Business Mailing Address
First Line	:	26401 CROWN VALLEY PKWY
Second Line	:	SUITE 101
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6302
Country	:	US
Telephone Number	:	949-348-4000
Fax Number	:

Provider Business Practice Location Address
First Line	:	26401 CROWN VALLEY PKWY
Second Line	:	SUITE 101
City	:	MISSION VIEJO
State	:	CA
Zip	:	92691-6302
Country	:	US
Telephone Number	:	949-348-4000
Fax Number	:

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

Provider Enumeration Date	:	04/28/2006
Last Update Date	:	03/07/2023

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