Jason Unruh, PA-C
Physician Assistant in San Diego, CA. Individual provider (NPI-1).
NPI number1033540554
StatusActive
Last updated in NPPESJan 8, 2025
Details
- NPI
- 1033540554
- Entity type
- Individual (NPI-1)
- Name
- Mr. Jason Unruh
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 9, 2013
- Certification date
- Jan 8, 2025
- Last updated
- Jan 8, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B No · DME Yes · Home health No · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 21321 | CA | Yes |
| 363AM0700X | Physician Assistant, Medical | 21321 | CA |
Practice location
3812 Bernice DrSan Diego, CA 92107-2702
Phone 619-861-9759 · Fax 619-684-3790
Mailing address
Po Box 99087San Diego, CA 92169-1087
Phone 619-861-9759 · Fax 619-684-3790
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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