| Doctor Name: | JESSIE E CORPUS |
| NPI Number: | 1245272046 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA12348 |
| Business Practice Address: | 750 E Walker St Ste A Orland, CA - 959632222 |
| Business Phone Number: | 5308654400 |
| Business Fax Number: | 5308657285 |
| Mailing Address: | 750 E Walker St Ste A, ORLAND |
| State: | CA |
| Postal Code: | 959632222 |
| Phone Number: | 5308654400 |
| Fax Number: | 5308657285 |
| NPI Enumeration Date: | 06/13/2006 |
| NPI Last Update Date: | 05/23/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA12348 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |