person
Mr. Jon Charles Lacy, PA
Medical Physician Assistant in Los Angeles, California
NPI 1588907638

Jon Charles Lacy is a Medical Physician Assistant based in Los Angeles, CA and is specialized in Medical. Jon Charles Lacy practices in Los Angeles, CA and has the professional credentials of PA. The NPI Number for Jon Charles Lacy is 1588907638 and holds a License No. PA22770 (California).

The current practice location address for Jon Charles Lacy is 6368 Hollywood Blvd, Los Angeles, CA and can be reached out via phone at 323-469-5555 and via fax at 323-466-0405.

Location: 6368 Hollywood Blvd, Los Angeles, CA, 90028-6320
person
Provider Profile Details
NPI Number
1588907638
Provider Name
Jon Charles Lacy
Credential
PA
Provider Entity Type
Individual
Gender
Male
Address
6368 Hollywood Blvd, Los Angeles, CA, 90028-6320
Phone Number
323-469-5555
Fax Number
323-466-0405
Provider Enumeration Date
03/27/2013
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
6368 Hollywood Blvd
City
State
Zip
90028-6320
Phone Number
323-469-5555
Fax Number
323-466-0405
person
Provider Business Mailing Address Details
Address
6368 Hollywood Blvd
City
State
Zip
90028-6320
Phone Number
323-469-5555
Fax Number
323-466-0405
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA22770 (California)
Definition
Definition to come...
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