MR. BRUCE L JACKSON


Address: 15863 Kasota Rd, Apple Valley, CA 92307-4507
Phone: 7609481454

MR. BRUCE L JACKSON (NPI# 1124072087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1124072087
Entity Type Individual
Full Name MR. BRUCE L JACKSON
Credential P.A.
Practice Address 15863 Kasota Rd
Apple Valley
CA 92307-4507
Mailing Address 11919 Hesperia Rd
Hesperia
CA 92345-1855
Practice Telephone 7609481454
Practice Fax Number 7609486100
Mailing Telephone 7609481454
Mailing Fax Number 7609486100
Enumeration Date 2006-05-22
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor X

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA14185 CA Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
CA GR0050902 05

Other Providers BRUCE JACKSON

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1992039291 Bruce C. Jackson Chiropractor 201 Brighton Park Blvd., Ste. 4, Frankfort, KY 40601-8447 2009-09-21
1851430532 Bruce W Jackson Dentist 111 Lilac Dr, Liberal, KS 67901 2007-02-06
1598133571 Bruce Jackson Registered Nurse 2828 1st Ave Ste 400, Huntington, WV 25702-1236 2015-09-09
1467711986 Bruce Jackson Case Manager/Care Coordinator 5715 S Broadway, Los Angeles, CA 90037-4131 2012-05-04
1598819567 Bruce E Jackson Counselor 5455 Almira Dr Se, Bremerton, WA 98311-8330 2007-01-23
1609883438 Bruce K Jackson Internal Medicine 520 N Prospect Ave, Ste. 300, Redondo Beach, CA 90277-3041 2006-08-02
1720039878 Bruce Arden Jackson II Dentist 4829 E Beltline Ave Ne, Grand Rapids, MI 49525-9747 2006-05-13

Office Location

Street Address 15863 KASOTA RD
City APPLE VALLEY
State CA
Zip Code 92307-4507

Providers in the same location

NPI Name Taxonomy Address Enumeration
1316204241 Afp Drugstore, Inc. Pharmacy 15863 Kasota Rd, Suite C, Apple Valley, CA 92307-4507 2012-04-17
1073647269 Desert Family Practice Associates Family Medicine 15863 Kasota Rd, Apple Valley, CA 92307-4507 2007-03-16
1114037942 Afp Drug Store Inc Pharmacy 15863 Kasota Rd, Ste C, Apple Valley, CA 92307-4507 2006-08-30
1154375053 Craig R Mueller Family Medicine 15863 Kasota Rd, Apple Valley, CA 92307-4507 2006-05-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679106025 Rajender S. Thakran, M.d., Inc Specialist 16030 Kamana Rd, Apple Valley, CA 92307 2020-02-13
1477119980 Harpreet Singh Nurse Practitioner 18300 Ca-18, Apple Valley, Ca 92307, Apple Valley, CA 92307 2019-05-10
1184120784 Frantz Jean-louis Nurse Practitioner 16134 Muni Rd, Apple Valley, CA 92307 2018-04-03
1053862078 Ashley M Morello Registered Nurse Universal Pain Management, 16179 Siskiyou, Apple Valley, CA 92307 2016-10-14
1891191680 Ann Simonds Marriage & Family Therapist 20601 Us Highway 18 Ste 123, Apple Valley, CA 92307 2014-11-06
1396147419 Aaa Family Medical Group Family Medicine 15995 Tuscola Rd Ste 202, Apple Valley, CA 92307 2014-09-19
1659780534 Relena Tran Pharmacist 20251 Highway 18, Apple Valley, CA 92307 2014-08-05
1639508526 Meagan Katherine Blades Physician Assistant 18300 Outer Hwy 18, Apple Valley, CA 92307 2013-11-01
1720341555 Jonathan Robert Cox Dermatology 18523 Corwin Rd Ste G, Apple Valley, CA 92307 2012-06-18
1821364365 Leary Sport and Spine Chiropractic Inc. Chiropractor 18564 Us Highway 18 Suite, 303, Apple Valley, CA 92307 2012-03-29
Find all providers in zip 92307

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144780016 Lauren Nicole Smith Physician Assistant 18112 Outer Hwy 18 Ste 101, Apple Valley, CA 92307-2211 2019-03-25
1275979742 Michelle A. Oropeza Physician Assistant 18112 Outer Hwy 18, Suite 101, Apple Valley, CA 92307-2211 2013-05-10
1639220080 Michelle Ann Wanner Physician Assistant 15115 Dove Trl, Attn: Minuteclinic, Apple Valley, MN 55124-7871 2007-01-14
1265469712 William Joseph Wilson Physician Assistant 18522 Highway 18, Suite 102, Apple Valley, CA 92307 2006-06-27
1053369009 Michael S Erskine Physician Assistant 16003 Tuscola Rd, Suite F, Apple Valley, CA 92307-1319 2006-05-04
1790315273 Sarah Barnes Physician Assistant 14655 Galaxie Ave, Apple Valley, MN 55124-8602 2020-01-23
1801433305 Vishal Verma Physician Assistant 19341 Bear Valley Rd Ste 101, Apple Valley, CA 92308-5152 2019-12-03
1235697376 Elias Christopher Frangos Physician Assistant 15962 Quantico Rd, Apple Valley, CA 92307-1302 2019-03-07
1184122046 Daniel Joseph Lunsford Durbin Physician Assistant 7300 147th St W Ste 204, Apple Valley, MN 55124-7850 2018-01-25
1194253377 Paul Sangwook Rhee Physician Assistant 18300 Us Highway 18, Apple Valley, CA 92307-2206 2017-05-31
Find all providers in APPLE VALLEY

Competitor

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City APPLE VALLEY
Zip Code 92307

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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