| David Horner Pc | |
|
41870 Garstin Dr Big Bear Lake CA 92315-2088 | |
| (909) 866-6501 | |
| Not Available |
| Full Name | David Horner Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 41870 Garstin Dr, Big Bear Lake, California |
| Authorized Official Name and Position | Carrie A Horner (TREASURER AND SECRETARY) |
| Authorized Official Contact | 5209790301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David Horner Pc Po Box 133021 Big Bear Lake CA 92315-8914 Ph: (520) 979-0301 | David Horner Pc 41870 Garstin Dr Big Bear Lake CA 92315-2088 Ph: (909) 866-6501 |
| NPI Number | 1619579422 |
|---|---|
| Provider Enumeration Date | 11/16/2020 |
| Last Update Date | 03/07/2023 |
| Medicare PECOS PAC ID | 6901211739 |
|---|---|
| Medicare Enrollment ID | O20210209000773 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619579422 | NPI | - | NPPES |
| 1407112923 | Other | NPI | |
| A141403 | Other | CA | CALIFORNIA MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Secondary |
| Provider Name | David J. Horner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407112923 PECOS PAC ID: 6709100415 Enrollment ID: I20160727001445 |
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