Individual
KEVIN EUGENE HEARN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3905 WARING RD, OCEANSIDE, CA 92056-4405
(760) 724-9000
(760) 724-3686
Mailing address
3905 WARING RD, OCEANSIDE, CA 92056-4405
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
52488
CA
363AS0400X
Surgical Physician Assistant
PA52488
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA52488
CA MEDICAL LICENSE #
CA
Enumeration date
08/07/2015
Last updated
03/01/2022
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