Individual
GAVIN MCMULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2101 N WATERMAN AVE, SAN BERNARDINO, CA 92404-4836
(909) 883-8711
Mailing address
29585 CHANDLER RD, HIGHLAND, CA 92346-5415
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
125600
CA
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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