Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Faison Jackson

Individual provider Physician Assistant · NPI 1366132813

Mr. Faison Jackson is a Physician Assistant in Los Angeles, California. Qualified in 2023, 3 years ago. Practices with Modern Physician Services PC, a 53-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

269 S San Pedro St
Los Angeles, CA 90012-3808
Phone: (213) 947-3600
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA64805 (CA)

Record details

NPI number1366132813
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 9, 2023
Last updated in NPPESJuly 13, 2026
Certification dateJuly 13, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Modern Physician Services Pc — 53 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations9 on file with Medicare

Other providers in Los Angeles