Jacob Thomas Bolz, PA-C is a medicare enrolled "Physician Assistant" in Lakeside, California. His current practice location is
12517 Lakeshore Dr, Lakeside, California. You can reach out to his office (for appointments etc.) via phone at
(619) 443-3843.
Jacob Thomas Bolz is licensed to practice in California (license number 52510) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386025682.
Provider's Profile
Full Name | Jacob Thomas Bolz |
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Gender | Male |
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Speciality | Physician Assistant |
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Location | 12517 Lakeshore Dr, Lakeside, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1386025682
- Provider Enumeration Date: 06/11/2015
- Last Update Date: 06/11/2015
Medicare PECOS Information:
- PECOS PAC ID: 8426360058
- Enrollment ID: I20150709002441
Medical Identifiers
Medical identifiers for Jacob Thomas Bolz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1386025682 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | 52510 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Thomas Bolz is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Jacob Thomas Bolz, PA-C 12517 Lakeshore Dr, Lakeside, CA 92040-3103 Ph: (619) 443-3843 | Jacob Thomas Bolz, PA-C 12517 Lakeshore Dr, Lakeside, CA 92040-3103 Ph: (619) 443-3843 |
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