| Jason Tai Kreider, NP | |
|
7741 Saint Bernard St Apt 2, Playa Del Rey, CA 90293-8318 | |
| (858) 245-6645 | |
| Not Available |
| Full Name | Jason Tai Kreider |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 7741 Saint Bernard St Apt 2, Playa Del Rey, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063034601 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 95014032 (California) | Primary |
| 363L00000X | Nurse Practitioner | 241073 (Arizona) | Secondary |
| Entity Name | West Coast Wound And Skin Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1437675980 PECOS PAC ID: 7315212834 Enrollment ID: O20171010002105 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason Tai Kreider, NP 7741 Saint Bernard St Apt 2, Playa Del Rey, CA 90293-8318 Ph: (858) 245-6645 | Jason Tai Kreider, NP 7741 Saint Bernard St Apt 2, Playa Del Rey, CA 90293-8318 Ph: (858) 245-6645 |
Vanessa Roman, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 322 Culver Blvd # 1182, Playa Del Rey, CA 90293 Phone: 323-403-8058 | |
Laquicha Westervelt, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8700 Pershing Drive, 4209, Playa Del Rey, CA 90293 Phone: 949-351-1044 |