Provider Demographics
NPI:1285985689
Name:ARNOLD, JASON LESLIE (DC)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:LESLIE
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 E GLENARM ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91105-3460
Mailing Address - Country:US
Mailing Address - Phone:626-799-4100
Mailing Address - Fax:
Practice Address - Street 1:183 E GLENARM ST
Practice Address - Street 2:SUITE 104
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91105-3460
Practice Address - Country:US
Practice Address - Phone:626-799-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32418111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor