Jacob Thomas Bolz, PA-C | |
12517 Lakeshore Dr, Lakeside, CA 92040-3103 | |
(619) 443-3843 | |
Not Available |
Full Name | Jacob Thomas Bolz |
---|---|
Gender | Male |
Speciality | Physician Assistant |
Location | 12517 Lakeshore Dr, Lakeside, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1386025682 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363A00000X | Physician Assistant | 52510 (California) | Primary |
Mailing Address | Practice Location Address |
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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 |
Christian Michael Kondan, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 13523 Sohail St, Lakeside, CA 92040 Phone: 619-564-9461 | |
Zach Glascox, Physician Assistant Medicare: Medicare Enrolled Practice Location: 10039 Vine St, Lakeside, CA 92040 Phone: 740-513-1087 |