Provider Demographics
NPI:1457377202
Name:POWERS, BRET CHRISTOPHER (DO)
Entity Type:Individual
Prefix:
First Name:BRET
Middle Name:CHRISTOPHER
Last Name:POWERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1007
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92564-1007
Mailing Address - Country:US
Mailing Address - Phone:951-696-9061
Mailing Address - Fax:951-696-4602
Practice Address - Street 1:802 MAGNOLIA AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-3104
Practice Address - Country:US
Practice Address - Phone:951-270-0882
Practice Address - Fax:951-270-0888
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9577207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A9577OtherLICENSE