Jennifer Kaori Fukasawa-Lara, PA-C
NPI #1477093714 in Banning, California
Provider Information
- NPI Number
- 1477093714
- Entity Type
- Individual
- Name
- Jennifer Kaori Fukasawa-Lara, PA-C
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Mar 6, 2017
- Last Updated
- Nov 12, 2020
Practice Location
- Address
- 600 N HIGHLAND SPRINGS AVE
- City
- Banning
- State
- California
- ZIP Code
- 92220-3046
- Phone
- (951) 845-1121
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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