Individual provider · Type 1 NPI
Ebrahim Mamour Jagne Sr., PA
Medical Physician Assistant · Santa Ana, CA
NPI number
1497808497
Active
Practice location
1329 E 1st St
Santa Ana, CA 92701-6310
Mailing address
1137 W 58th Pl
Los Angeles, CA 90044-3702
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA 12322 (CA) |
Medical Physician Assistant: Definition to come...
Another provider at this address
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About NPI 1497808497
Ebrahim Mamour Jagne Sr., PA's National Provider Identifier is 1497808497, issued on Jan 21, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Santa Ana, CA. The record was last updated on Jul 8, 2007.