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1851512560
JESSE INGRAM
FONTANA, CA
NPI
1851512560
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: CA PA13419)
Enumeration Date
2007-05-01
Last Update Date
2021-11-29
Business Address
Mr. JESSE INGRAM PA-C
9985 SIERRA AVE
FONTANA, CA 92335-6720
Phone number: 909-427-5525
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Mailing Address
Mr. JESSE INGRAM PA-C
1033 LA MARILLO CIR
CORONA, CA 92879-8234
Phone number: 909-427-5525
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