Provider Demographics
NPI:1811453525
Name:LEARMAN, CAMERON (PA)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:
Last Name:LEARMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 MICHELSON DR APT 3201
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-4316
Mailing Address - Country:US
Mailing Address - Phone:989-450-9477
Mailing Address - Fax:
Practice Address - Street 1:7140 INDIANA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-4544
Practice Address - Country:US
Practice Address - Phone:951-358-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-18
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA56509363A00000X
CA56509363AM0700X
MI5601010612363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical