Healthcare Provider Details

I. General information

NPI: 1114599693
Provider Name (Legal Business Name): PRECISION SURGICAL ASSISTING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2021
Last Update Date: 07/14/2021
Certification Date: 07/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2487 S GILBERT RD STE 106-125
GILBERT AZ
85295-2804
US

IV. Provider business mailing address

2487 S GILBERT RD STE 106-125
GILBERT AZ
85295-2804
US

V. Phone/Fax

Practice location:
  • Phone: 480-695-8139
  • Fax: 480-219-5202
Mailing address:
  • Phone: 480-695-8139
  • Fax: 480-219-5202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number
License Number State

VIII. Authorized Official

Name: MS. CHRISTINA MARGARITA BALDENEGRO
Title or Position: RN CERTIFIED FIRST ASSISTANT
Credential: RNFA, CSFA
Phone: 480-695-8139