SAMUEL JARED SPERRY PA-C NPI 1689941346

NPI Information

NPI: 1689941346
Provider Name: SAMUEL JARED SPERRY, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
401 E HIGHLAND AVE STE 351
SAN BERNARDINO, CA
ZIP 92404
Phone: (909) 475-8611
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Samuel Jared Sperry, PA-C is a medical physician assistant in San Bernardino, CA with 13 years of experience. Samuel Jared Sperry, PA-C NPI is 1689941346. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

401 E HIGHLAND AVE STE 351
SAN BERNARDINO, CA
ZIP 92404-830
Phone: (909) 475-8611
Fax: (909) 475-2566

The NPI 1689941346 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/23/2011 and was last updated on 3/30/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA22002	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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