Jonathan K Stobaugh, PA-C
Physician Assistant in San Bernardino, CA. Individual provider (NPI-1).
NPI number1063447647
StatusActive
Last updated in NPPESSep 21, 2017
Details
- NPI
- 1063447647
- Entity type
- Individual (NPI-1)
- Name
- Jonathan K Stobaugh
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 11, 2006
- Last updated
- Sep 21, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA10962 | CA | Yes |
Practice location
401 E Highland AveSuite 251
San Bernardino, CA 92404-3803
Phone 909-882-4605 · Fax 909-475-2680
Mailing address
3400 Data DrAttn: Credentialing/Payer Enrollment
Rancho Cordova, CA 95670-7956
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All 86 Physician Assistant providers in San Bernardino · All 7,202 providers in San Bernardino
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