| Edward Kemp, PA | |
|
400 N Pepper Ave, Colton, CA 92324-1801 | |
| (909) 580-3390 | |
| Not Available |
| Full Name | Edward Kemp |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 400 N Pepper Ave, Colton, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235533134 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 52062 (California) | Primary |
| Entity Name | Southern California Permanente Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770515280 PECOS PAC ID: 6002729175 Enrollment ID: O20031110000678 |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Kemp, PA 400 N Pepper Ave # 205, Colton, CA 92324-1801 Ph: (909) 580-6353 | Edward Kemp, PA 400 N Pepper Ave, Colton, CA 92324-1801 Ph: (909) 580-3390 |
Richard Anthony Benavidez, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-1000 |
Tiffany Jackie Hwang, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave # 205, Colton, CA 92324 Phone: 909-331-9598 |
Lawrence David Gates, P.A-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N. Pepper Avenue, Colton, CA 92324 Phone: 909-580-1400 |
Mrs. Amy Elizabeth Dahlberg, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-354-2195 |
Olivia Sophia Zetty, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave Ste 2m206, Colton, CA 92324 Phone: 317-900-3912 |
Brian Kent Heaton, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-3390 |
Emma Werner Oliver, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-1000 |