| Organization Name: | BONA FIDE SURGICAL ASSISTANCE |
| NPI Number: | 1003270539 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHANIE D. BARON (OWNER) |
| Mailing Address: | 305 Springfield St Apt 7 Claremont |
| State: | CA US |
| Postal Code: | 917115260 |
| Phone Number: | 9095604466 |
| Fax Number: | |
| NPI Enumeration Date: | 04/11/2016 |
| NPI Last Update Date: | 04/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA 17201 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |