CLYDE JAMES BURGESS JR. (NPI# 1114117470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114117470 |
| Entity Type | Individual |
| Full Name | CLYDE JAMES BURGESS JR. |
| Credential | MSO |
| Practice Address |
31616 Loma Linda Rd Temecula CA 92592-1639 |
| Practice Telephone | 9512656552 |
| Mailing Telephone | 9512656552 |
| Enumeration Date | 2007-08-01 |
| Last Update Date | 2007-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
31616 LOMA LINDA RD |
| City | TEMECULA |
| State | CA |
| Zip Code | 92592-1639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366051625 | Huey Q Tran, Dds, Inc. | Dentist | 33321 Temecula Parkway Ste 104, Temecula, CA 92592 | 2020-07-23 |
| 1902425465 | Isak Elkayam | Student in an Organized Health Care Education/Training Program | 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-14 |
| 1033738737 | Jordan Buckley | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-13 |
| 1366071052 | Areg Hovsepyan | Internal Medicine | 31700 Temecula Parkway Parkway Suites # 2- Gme, Temecula, CA 92592 | 2020-04-03 |
| 1558906982 | Session Sync, Inc. | Point of Service | 44262 Marcelina Court, Temecula, CA 92592 | 2019-11-08 |
| 1962964718 | Krishna Theja Reddy Venkatamuni Reddy | Student in an Organized Health Care Education/Training Program | Uhs Socal Medical Education Consortium, 31700 Temecula Parkway, Parkway Suites # 2- Gme, Temecula, CA 92592 | 2019-04-02 |
| 1598220246 | Shanay Lamont Moore | Behavior Technician | 30660 Milky Way Dr., V174, Temecula, CA 92592 | 2019-02-07 |
| 1477029502 | Tibbitts Temecula Dental Group | Clinic/Center | 32909 Temecula Parkway Ste 102, Temecula, CA 92592 | 2018-10-16 |
| 1720563364 | Nicole Louise Hernandez | Behavioral Analyst | 32144 Camino Nunez, Temecula, CA 92592 | 2018-09-29 |
| 1174010664 | Kiet Chau | Pharmacist | 32228 Highway 79 South, Temecula, CA 92592 | 2018-04-19 |
| Find all providers in zip 92592 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| 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 perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134572662 | Natalie Anastasia Nealeigh | Physician Assistant | 40469 Calle Katerine, Temecula, CA 92591-6981 | 2016-07-20 |
| 1760837314 | Francis Ezpeleta Galura | Physician Assistant | 30197 Corte Plata, Temecula, CA 92591-1900 | 2016-05-02 |
| 1053778274 | Dermatology Specialists, Inc | Physician Assistant | 31469 Rancho Pueblo Rd # 101, Temecula, CA 92592-4834 | 2016-01-19 |
| 1902298565 | Shannon Miller | Physician Assistant | 40674 Calle Cancion, Temecula, CA 92592-9472 | 2015-02-19 |
| 1245669340 | James Brinkman | Physician Assistant | 32032 Cala Gerona, Temecula, CA 92592-3657 | 2013-11-08 |
| 1932494499 | Jacqueline Rose Weir | Physician Assistant | 41715 Winchester Rd Ste 101, Temecula, CA 92590-4853 | 2011-06-13 |
| 1326340225 | John Denton Olson | Physician Assistant | 31675 Calle Barcaldo, Temecula, CA 92592-3611 | 2010-11-28 |
| 1487834644 | Ryan Daniel Rowan | Physician Assistant | 44054 Margarita Rd, Suite 1, Temecula, CA 92592-2773 | 2007-11-05 |
| 1215130562 | Keith David Rouleau | Physician Assistant | 29605 Solana Way, #n6, Temecula, CA 92591-3758 | 2007-06-06 |
| 1669693156 | Deanna Carlsberg | Physician Assistant | 32505 Galatina St, Temecula, CA 92592-3880 | 2007-05-01 |
| Find all providers in TEMECULA | ||||
Please comment or provide details below to improve the information on CLYDE JAMES BURGESS JR..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.