Kenrick Carlyle Bourne in Colton - Physician Assistant
Kenrick Carlyle Bourne - NPI 1063690931
Kenrick Carlyle Bourne is a Physician Assistant in Colton, California. Kenrick Carlyle Bourne practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kenrick Carlyle Bourne is 1063690931. The last update date is 2008-02-04.
Kenrick Carlyle Bourne's current location address is 3076 Prado Ln, Colton, California. You can contact this provider via phone number 9098256053. The mailing address for Kenrick Carlyle Bourne is 3076 Prado Ln, Colton, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenrick Carlyle Bourne |
|---|---|
| Address | 3076 Prado Ln, Colton, California |
| Phone Number | 9098256053 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1063690931 |
|---|---|
| Provider Enumeration Date | 2008-02-04 |
| Last Updated Date | 2008-02-04 |
Provider Mailing Address Detail
| Address | 3076 Prado Ln |
|---|---|
| City | Colton |
| State | California (CA) |
| Post Code | 923249794 |
| Phone Number | 9098256053 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA12018 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique 10-digit identification code issued to Kenrick Carlyle Bourne by the Centers for Medicare & Medicaid Services?
The Kenrick Carlyle Bourne has been assigned the NPI (National Provider Identifier) 1063690931 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Where is the Kenrick Carlyle Bourne located?
The Kenrick Carlyle Bourne is located at 3076 Prado Ln, Colton, CA 923249794.
What is Kenrick Carlyle Bourne's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Kenrick Carlyle Bourne's specialized field of practice is Physician Assistant, and the corresponding taxonomy code that categorizes this area of specialization is 363A00000X.
When did the Kenrick Carlyle Bourne receive its 1063690931?
The Kenrick Carlyle Bourne was issued its 1063690931 on 2008-02-04, which is the date when the organization was assigned this unique identifier.
As of what date were the details related to Kenrick Carlyle Bourne most recently updated or revised?
The information pertaining to Kenrick Carlyle Bourne, including its address, specialty, and other relevant details, was last updated or revised on 2008-02-04.
NPI Number: 1720081763
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