Provider Demographics
NPI:1902017700
Name:BATIN, JOHN (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:BATIN
Suffix:
Gender:M
Credentials: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:P.O BOX 1163
Mailing Address - Street 2:
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92286-4088
Mailing Address - Country:US
Mailing Address - Phone:760-228-2935
Mailing Address - Fax:
Practice Address - Street 1:57675 29 PALMS HWY
Practice Address - Street 2:STE 111
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284-3098
Practice Address - Country:US
Practice Address - Phone:760-365-8500
Practice Address - Fax:760-365-8599
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13442363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant