Student
Student provides Physician Assistant services in Redlands, California. Registered with an NPI since 2016.
- In the registry since
- 2016
Practice location Address checks out
1640 Juanita LnRedlands, CA 92373-7142 Not confirmed with CMS for 10 years — call before visiting
Phone: (951) 756-8989
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Physician Assistant (primary) | Taxonomy 363A00000X |
|---|
Record details
| NPI number | 1174079347 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Cullen Mack — Student · (951) 756-8989 |
| NPI enumerated | August 28, 2016 |
| Last updated in NPPES | August 28, 2016 |
| Mailing address | 1640 Juanita Ln, Redlands, CA 92373-7142 |
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