Clyde James Burgess JR. MSO

NPI 1114117470 - Physician Assistant - 363A00000X

NPI Details
NPI 1114117470
Gender Male
Enumeration Date 08/01/2007
Last Updated 08/01/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
31616 LOMA LINDA RD
TEMECULA CA, 92592-1639, US
Phone (951) 265-6552
Fax
Business Location
31616 LOMA LINDA RD
TEMECULA CA, 92592-1639, US
Phone (951) 265-6552
Fax
Toxanomy
Taxonomy Code 363A00000X
License State
License Number
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According to our database, Clyde James Burgess JR. MSO NPI is 1114117470, taxonomy code is 363A00000X Clyde James Burgess JR. MSO physically located at 31616 Loma Linda Rd, Temecula CA, 92592-1639. NPI Number Clyde James Burgess JR. MSO has the Individual type.

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1114117470 NPI number is provided on an as is basis without warranty of any kind. 1114117470 is maintained by the National Plan & Provider Enumeration System. The contents of Clyde James Burgess JR. MSO are for informational purposes only.