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

Mr. Ivan Jesus Palacios, PA-C

Individual provider Surgical Physician Assistant · NPI 1790310449

Mr. Ivan Jesus Palacios, PA-C is a Physician Assistant in San Francisco, California. Qualified in 2020, 6 years ago. Works from 2 locations. Licensed in California and Texas.

Years since qualifying
6
Licensed in
CA, TX
In the registry since
2020
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1975 4th St
San Francisco, CA 94143-2351
Phone: (415) 476-3501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6621 Fannin St, Houston, TX 77030-2399 — (832) 824-1000

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA66810 (CA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA14405 (TX)

Record details

NPI number1790310449
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 3, 2020
Last updated in NPPESJuly 24, 2025
Certification dateJuly 24, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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