Individual
CLYDE JAMES BURGESS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSO
Contact information
Practice address
31616 LOMA LINDA RD, TEMECULA, CA 92592-1639
(951) 265-6552
Mailing address
31616 LOMA LINDA RD, TEMECULA, CA 92592-1639
(951) 265-6552
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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