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NPI Code Detail

MEDICARE: MRS. BRENDA ANN BUSHEY PA-C

MEDICARE: MRS. BRENDA ANN BUSHEY PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA13813CA

General Provider Information

NPI Number : 1700827664
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. BRENDA ANN BUSHEY PA-C
Provider Business Mailing Address
First Line : 22 CORPORATE PLAZA DR
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-7901
Country : US
Telephone Number : 949-722-7038
Fax Number : 949-630-4930
Provider Business Practice Location Address
First Line : 22 CORPORATE PLAZA DR
Second Line :
City : NEWPORT BEACH
State : CA
Zip : 92660-7901
Country : US
Telephone Number : 949-722-7038
Fax Number : 949-630-4930
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/09/2006
Last Update Date : 07/08/2007

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Directions to “ MRS. BRENDA ANN BUSHEY PA-C” Practice Location

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