Individual
BRENT R. PALMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1300 AVENIDA VISTA HERMOSA, SUITE 240, SAN CLEMENTE, CA 92673-6315
(949) 489-4290
(949) 489-4293
Mailing address
600 CORPORATE DR, STE 100, LADERA RANCH, CA 92694-2107
(949) 388-8022
(949) 388-8033
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA16774
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00127807
RAILROAD MEDICARE
CA
Enumeration date
10/06/2006
Last updated
02/19/2018
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