Jessie De La O
Medical Specialty
Professional ID
- NPI: 1972720597
- PECOS ID: 6901824291
- Enrollment ID: I20051104000443
- Credential(MD, DO, DPM): PA
- Medical School: Stanford University School Of Medicine
- Medical School Graduation Year: 2004
Hospital Service
- Hospital CCN1: 050235
- Business Name (LBN)1: Providence Saint Joseph Medical Ctr
Medical Practices
- Organization Name: Providence Medical Institute
- Group Practice ID assigned by PECOS: 5991609737
- Number of Group Practice member: 230
Location
- Address1: 21501 Avalon Blvd
- Address2: Suite 100
- City: Carson
- State: California
- Zip Code: 90745
- Phone Number: (310)835-6627
Location
- Address1: 24035 Newhall Ranch Rd
- Address2:
- City: Santa Clarita
- State: California
- Zip Code: 91355
- Phone Number: (661)291-3444
Medicare
- Medicare Assignment: Yes
- Report Quality of Care to Physician Quality Reporting System (PQRS): Yes
- Used Electronic health record (EHR):