Provider Demographics
NPI:1083855407
Name:BAILEY, BRYNN CHRISTIN (MS, PA-C)
Entity Type:Individual
Prefix:
First Name:BRYNN
Middle Name:CHRISTIN
Last Name:BAILEY
Suffix:
Gender:F
Credentials:MS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26502 LA QUILLA LN
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:31897 DEL OBISPO ST STE 115
Practice Address - Street 2:
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-3207
Practice Address - Country:US
Practice Address - Phone:949-429-3200
Practice Address - Fax:949-429-3600
Is Sole Proprietor?:No
Enumeration Date:2009-03-14
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20104363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical