Individual
PATRICK TYE CREASY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
900 E WASHINGTON ST, SUITE 301, COLTON, CA 92324-7111
(909) 370-0300
(909) 370-0303
Mailing address
900 E WASHINGTON ST, SUITE 301, COLTON, CA 92324-7111
(909) 370-0300
(909) 370-0303
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21414
CA
363AS0400X
Surgical Physician Assistant
PA21414
CA
Other
Enumeration date
01/12/2011
Last updated
10/08/2013
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