Mr Blaze Ryan Gannon, PA-C in Colton, CA

Mr Blaze Ryan Gannon, PA-C is a Physician Assistant based in Colton, California. Mr Blaze Ryan Gannon is licensed to practice in California (license number PA18462) and his current practice location is 400 N Pepper Ave, Orthopaedic Admin, Colton, California. He can be reached at his office (for appointments etc.) via phone at (909) 580-6330.

NPI number for Mr Blaze Ryan Gannon is 1588764245 and his current mailing address is 1901 W Lugonia Ave Ste 230, Redlands, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1588764245.

Contact Information

	Mr Blaze Ryan Gannon, PA-C
	400 N Pepper Ave, Orthopaedic Admin, Colton, CA 92324-1801
	(909) 580-6330
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Blaze Ryan Gannon
Gender	Male
Speciality	Physician Assistant
Location	400 N Pepper Ave, Colton, California
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1588764245
Provider Enumeration Date: 09/23/2006
Last Update Date: 02/08/2010

Medical Identifiers

Medical identifiers for Mr Blaze Ryan Gannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588764245	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA18462 (California)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Blaze Ryan Gannon is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Blaze Ryan Gannon, PA-C 1901 W Lugonia Ave Ste 230, Redlands, CA 92374-9705 Ph: (909) 557-1600	Mr Blaze Ryan Gannon, PA-C 400 N Pepper Ave, Orthopaedic Admin, Colton, CA 92324-1801 Ph: (909) 580-6330

Reviews and Comments

Physician Assistant Nurses in Colton, CA

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: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave # 205, Colton, CA 92324 Phone: 909-331-9598
Lawrence David Gates, P.A-C Physician Assistant Medicare: Medicare Enrolled 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
Edward V. Schelert, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 400 North Pepper Ave, Arrowhead Regional Medical Center, Colton, CA 92324 Phone: 909-580-1000 Fax: 909-580-3333
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: Not Enrolled in Medicare Practice Location: 400 N Pepper Ave, Colton, CA 92324 Phone: 909-580-1000

Mr Blaze Ryan Gannon, PA-C - Physician Assistant in Colton, CA