Individual provider · Type 1 NPI

Jerry L. Tyner

Student in an Organized Health Care Education/Training Program · Fountain Valley, CA

NPI number 1851704407 Active

Practice location

17350 Mount Herrmann St Ste A
Fountain Valley, CA 92708-4114

Call (714) 444-3463 Map

Fax (714) 444-1768

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X22360 (CA)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1851704407

Jerry L. Tyner's National Provider Identifier is 1851704407, issued on Jun 10, 2014. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fountain Valley, CA. The record was last updated on Jun 10, 2014.