Clyde James Burgess JR., MSO

NPI #1114117470 in Temecula, California

Provider Information

NPI Number: 1114117470
Entity Type: Individual
Name: Clyde James Burgess JR., MSO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: MSO
Enumeration Date: Aug 1, 2007
Last Updated: Aug 1, 2007

Practice Location

Address: 31616 LOMA LINDA RD
City: Temecula
State: California
ZIP Code: 92592-1639
Phone: (951) 265-6552

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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