Individual
MR. BRUCE W HINTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
68555 RAMON RD, CATHEDRAL CITY, CA 92234-3310
(760) 507-3310
(858) 634-6974
Mailing address
PO BOX 2369, BORREGO SPRINGS, CA 92004-2369
(619) 873-3538
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA200691
LA
363AM0700X
Medical Physician Assistant
Primary
21697
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2398954
—
LA
Enumeration date
07/27/2011
Last updated
10/20/2020
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