Provider Demographics
NPI:1053618835
Name:BRET POWERS DO INC
Entity type:Organization
Organization Name:BRET POWERS DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BRET
Authorized Official - Middle Name:
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:951-270-0882
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:951-719-3330
Mailing Address - Fax:951-296-6741
Practice Address - Street 1:4234 RIVERWALK PKWY
Practice Address - Street 2:STE 200
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-8510
Practice Address - Country:US
Practice Address - Phone:951-270-0882
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-14
Last Update Date:2011-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9577207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty