Jorge Gonzalo Jara, P.A.

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110005612 Issued in VA

Practice address

200 Mercy Circle
Camp Pendleton, CA 92055

Phone

(760) 719-3308

NPI assigned

Apr 30, 2015

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: jorge.jara.1@24997.direct.athenahealth.com

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1215314042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555191",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555191",
            "telephone_number": "760-719-3308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "760-719-3308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARA",
        "first_name": "JORGE",
        "middle_name": "GONZALO",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-30",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110005612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Blair Isgitt, PHD
• Kara L Jablonski, PHARMD
• Minal Damani Jackson, MD
• Jonas Jose Jacoba, RN
• Tyler David James, MD
• Jerry Alonza Jarrett Jr., DDS
• Brandon L Joa, MD
• Christine Hayoon Joh, PHARM.D.
• Andrea Jones, AP, LAC., DAOM
• Craig Taylor Jones, PHYSICIAN ASST.

• Medical Physician Assistant in Camp Pendleton, CA
• Providers in Camp Pendleton, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.