Individual
DEREK CARL BRONSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 459-4641
Mailing address
1800 HARRISON ST, FL 7, OAKLAND, CA 94612-3466
(505) 620-0500
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/18/2017
Last updated
12/28/2021
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