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Individual

KEVIN EUGENE HEARN

Active
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Individual

KEVIN EUGENE HEARN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

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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