Provider Demographics
NPI:1023185097
Name:MCBRIDE, DALE G (PA)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:G
Last Name:MCBRIDE
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1414 LA GRANDE AVE
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-6516
Mailing Address - Country:US
Mailing Address - Phone:530-673-9373
Mailing Address - Fax:530-673-9374
Practice Address - Street 1:1414 LA GRANDE AVE
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-6516
Practice Address - Country:US
Practice Address - Phone:530-673-9373
Practice Address - Fax:530-673-9374
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA10222363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant