Provider Demographics
NPI:1588658660
Name:CALL, JASON (PA-C)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:CALL
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:1111 EMERALD BAY RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-6207
Mailing Address - Country:US
Mailing Address - Phone:530-543-5659
Mailing Address - Fax:530-541-8723
Practice Address - Street 1:935 MICA DR STE 13
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89705-7181
Practice Address - Country:US
Practice Address - Phone:775-783-3065
Practice Address - Fax:775-267-1829
Is Sole Proprietor?:No
Enumeration Date:2005-09-06
Last Update Date:2016-04-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVPA1685363A00000X
CAPA53078363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant