Provider Demographics
NPI:1386761245
Name:ARMSTRONG, JEFFREY SANDS (PA)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:SANDS
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-3942
Mailing Address - Country:US
Mailing Address - Phone:209-388-0884
Mailing Address - Fax:619-437-5995
Practice Address - Street 1:129 N 5TH ST
Practice Address - Street 2:
Practice Address - City:CHOWCHILLA
Practice Address - State:CA
Practice Address - Zip Code:93610-2820
Practice Address - Country:US
Practice Address - Phone:559-665-0275
Practice Address - Fax:559-665-7126
Is Sole Proprietor?:No
Enumeration Date:2007-03-24
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16531363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM19998HMedicaid
CARHM19998HMedicaid