Individual
JEREMY JOSEPH BIRD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
PO BOX 232410, SAN DIEGO, CA 92193-2410
(800) 926-8273
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
53170
CA
363AS0400X
Surgical Physician Assistant
200447
LA
363AS0400X
Surgical Physician Assistant
53170
CA
363L00000X
Nurse Practitioner
Primary
18833
CA
363L00000X
Nurse Practitioner
AP06311
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01528549
—
MS
05
—
2133845
—
LA
Enumeration date
10/30/2009
Last updated
08/30/2023
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