Provider Demographics
NPI:1992741912
Name:ABSHIRE, BRET (MD)
Entity type:Individual
Prefix:DR
First Name:BRET
Middle Name:
Last Name:ABSHIRE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25150 HANCOCK AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5987
Mailing Address - Country:US
Mailing Address - Phone:951-587-3739
Mailing Address - Fax:951-698-5213
Practice Address - Street 1:25150 HANCOCK AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5987
Practice Address - Country:US
Practice Address - Phone:951-587-3739
Practice Address - Fax:951-698-5213
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA71689207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A716890Medicaid
CAH40084Medicare UPIN
CAWA71689AMedicare ID - Type Unspecified