Mrs. BRIANA LAUREN BOURBON PA
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1326862616- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA
- Status
- Active
Contact & Location
- Address
- 1700 COFFEE RD # 1, MODESTO, CA, 953552803
- Phone
- (209) 572-7251
Specialties & Taxonomies
Physician Assistant
Primary License: CA #65708
All Addresses
MAILING
1700 COFFEE RD # 1
MODESTO, CA, 953552803