Jacob Thomas Bolz, PA-C
NPI #1386025682 in Lakeside, California
Provider Information
- NPI Number
- 1386025682
- Entity Type
- Individual
- Name
- Jacob Thomas Bolz, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Jun 11, 2015
- Last Updated
- Jun 11, 2015
Practice Location
- Address
- 12517 LAKESHORE DR
- City
- Lakeside
- State
- California
- ZIP Code
- 92040-3103
- Phone
- (619) 443-3843
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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