Blaze Ryan Gannon in Colton - Physician Assistant
Blaze Ryan Gannon - NPI 1588764245
Blaze Ryan Gannon is a Physician Assistant in Colton, California. Blaze Ryan Gannon practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Blaze Ryan Gannon is 1588764245. The last update date is 2010-02-08.
Blaze Ryan Gannon's current location address is 400 N Pepper Ave, Colton, California. You can contact this provider via phone number 9095806330. The mailing address for Blaze Ryan Gannon is 400 N Pepper Ave, Colton, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Blaze Ryan Gannon |
|---|---|
| Address | 400 N Pepper Ave, Colton, California |
| Phone Number | 9095806330 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1588764245 |
|---|---|
| Provider Enumeration Date | 2006-09-23 |
| Last Updated Date | 2010-02-08 |
Provider Mailing Address Detail
| Address | 400 N Pepper Ave |
|---|---|
| City | Colton |
| State | California (CA) |
| Post Code | 923241801 |
| Phone Number | 9095806330 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA18462 |
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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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Post Comment/ Review Below
What is the unique provider identifier assigned to Blaze Ryan Gannon?
The Blaze Ryan Gannon has been issued the NPI (National Provider Identifier) 1588764245 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you share the physical location details of Blaze Ryan Gannon?
The Blaze Ryan Gannon is situated at 400 N Pepper Ave, in the city of Colton, state of CA, with the zip code 923241801.
What is Blaze Ryan Gannon's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Blaze Ryan Gannon is Physician Assistant, and the taxonomy code that classifies this field of practice is 363A00000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1588764245 to Blaze Ryan Gannon?
The Centers for Medicare & Medicaid Services originally issued the 1588764245 to Blaze Ryan Gannon on 2006-09-23.
When was the information regarding Blaze Ryan Gannon, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Blaze Ryan Gannon, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2010-02-08.