Doctor Name: | EDNA ANN DEAN |
NPI Number: | 1467425637 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA 11401 |
Business Practice Address: | 552 Sespe Ave Fillmore, CA - 930151957 |
Business Phone Number: | 8055242000 |
Business Fax Number: | |
Mailing Address: | 407 Sierra Vista Ave, FILLMORE |
State: | CA |
Postal Code: | 930151669 |
Phone Number: | 8055247070 |
Fax Number: | 8055241847 |
NPI Enumeration Date: | 02/09/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA 11401 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |