| Ms Keturah Braithwaite, PA-C | |
|
941 Kendall Dr Ste C, San Bernardino, CA 92407-4156 | |
| (302) 354-7476 | |
| Not Available |
| Full Name | Ms Keturah Braithwaite |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 941 Kendall Dr Ste C, San Bernardino, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023773579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 61065 (California) | Primary |
| Entity Name | Carbon Health Medical Group of California PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1417294232 PECOS PAC ID: 9032340047 Enrollment ID: O20140314001276 |
| Entity Name | Global Integrated Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1578019485 PECOS PAC ID: 6709173487 Enrollment ID: O20160923000187 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Keturah Braithwaite, PA-C Po Box 90483, San Bernardino, CA 92427-1483 Ph: (302) 354-7476 | Ms Keturah Braithwaite, PA-C 941 Kendall Dr Ste C, San Bernardino, CA 92407-4156 Ph: (302) 354-7476 |
Nicholas Walther, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 |
Deval Dave, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2101 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-883-8711 |
Daniel E Kim, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 284 E Highland Ave, San Bernardino, CA 92404 Phone: 909-883-1098 Fax: 909-883-0653 |
Ms. Tanisha G Williams, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 1805 Medical Center Dr, San Bernardino, CA 92411 Phone: 909-887-6333 Fax: 909-887-1985 |
Miss Sara Natour, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 2334 N Sierra Way, San Bernardino, CA 92405 Phone: 909-747-2715 |
Mr. Richard Tang, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1364 N Waterman Ave, San Bernardino, CA 92404 Phone: 909-474-9952 |
Jonathan K Stobaugh, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 401 E Highland Ave, Suite 251, San Bernardino, CA 92404 Phone: 909-882-4605 Fax: 909-475-2680 |