Individual
ERIN KELLE DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1415 ROSS AVE. /EL CENTRO REGIONAL MED.CTR., C/O DR.MICHAEL K. BERRY M.D., EL CENTRO, CA 92243-4306
(760) 339-7100
Mailing address
393 COUNTRYSIDE DR, EL CENTRO, CA 92243-8403
(817) 368-6666
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20643
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033446695
—
CA
Enumeration date
11/03/2009
Last updated
01/20/2010
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