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Dr. Jason K Boutros, MD
Specialist in Pasadena, California
NPI 1942243563

Jason K Boutros is a Specialist based in Pasadena, CA. Jason K Boutros practices in Pasadena, CA and has the professional credentials of MD. The NPI Number for Jason K Boutros is 1942243563 and holds a License No. A42891 (California).

The current practice location address for Jason K Boutros is 2554 E Washington Blvd, Pasadena, CA and can be reached out via phone at 626-798-8923 and via fax at 626-798-0258.

Location: 2554 E Washington Blvd, Pasadena, CA, 91107-1445
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942243563
Provider Name
Jason K Boutros
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2554 E Washington Blvd, Pasadena, CA, 91107-1445
Phone Number
626-798-8923
Fax Number
626-798-0258
Provider Enumeration Date
06/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00A42891 05 CA
A42891 01 CA LICENSE NO.
institution
Provider Business Practice Location Address Details
Address
2554 E Washington Blvd
City
Pasadena
State
California
Zip
91107-1445
Phone Number
626-798-8923
Fax Number
626-798-0258
person
Provider Business Mailing Address Details
Address
2554 E Washington Blvd
City
Pasadena
State
California
Zip
91107-1445
Phone Number
626-798-8923
Fax Number
626-798-0258
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
A42891 (California)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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