Basic Information
| Provider Information | |||||||||
| NPI: | 1063523595 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PASKIN | ||||||||
| FirstName: | JARED | ||||||||
| MiddleName: | ARTHUR | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3768 | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953443768 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097229066 | ||||||||
| FaxNumber: | 2093831522 | ||||||||
| Practice Location | |||||||||
| Address1: | 535 W 25TH ST | ||||||||
| Address2: | |||||||||
| City: | MERCED | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953402801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2097229066 | ||||||||
| FaxNumber: | 2093831522 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/31/2006 | ||||||||
| LastUpdateDate: | 12/11/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G45379 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 00G453790 | 05 | CA | MEDICAID |