Doctor Name: | MR. MICHAEL JAMES VANHORN |
NPI Number: | 1609022151 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | NP |
License Number: | 503195 |
Business Practice Address: | 24511 W Jayne Ave Coalinga, CA - 932109503 |
Business Phone Number: | 5599343945 |
Business Fax Number: | |
Mailing Address: | 24511 W Jayne Ave, COALINGA |
State: | CA |
Postal Code: | 932109503 |
Phone Number: | 5599343945 |
Fax Number: | |
NPI Enumeration Date: | 08/15/2008 |
NPI Last Update Date: | 08/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 503195 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |