| Irina Jasper Md A Professional Corp | |
|
960 E Green St Ste 286 Pasadena CA 91106-2420 | |
| (626) 356-0340 | |
| (626) 356-0390 |
| Full Name | Irina Jasper Md A Professional Corp |
|---|---|
| Speciality | Internal Medicine |
| Location | 960 E Green St Ste 286, Pasadena, California |
| Authorized Official Name and Position | Patricia Gallegos (OFFICE MANAGER) |
| Authorized Official Contact | 6263560340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Irina Jasper Md A Professional Corp 960 E Green St Ste 286 Pasadena CA 91106-2420 Ph: (626) 356-0340 | Irina Jasper Md A Professional Corp 960 E Green St Ste 286 Pasadena CA 91106-2420 Ph: (626) 356-0340 |
| NPI Number | 1538482567 |
|---|---|
| Provider Enumeration Date | 03/04/2010 |
| Last Update Date | 01/25/2018 |
| Medicare PECOS PAC ID | 0547395428 |
|---|---|
| Medicare Enrollment ID | O20100317000431 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538482567 | NPI | - | NPPES |
| 1356421903 | Other | CA | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Irina Jasper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356421903 PECOS PAC ID: 7517943293 Enrollment ID: I20040624001126 |
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