| Organization Name: | PHYSICIAN ASSISTANT SURGICAL ASSIST, INC |
| NPI Number: | 1093059248 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRIAN SPENCER (OWNER) |
| Mailing Address: | 1001 Halidon Way Folsom |
| State: | CA US |
| Postal Code: | 956308537 |
| Phone Number: | 7024582304 |
| Fax Number: | |
| NPI Enumeration Date: | 11/11/2012 |
| NPI Last Update Date: | 11/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | PA12373 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |