Healthcare Provider Details

I. General information

NPI: 1174457253
Provider Name (Legal Business Name): SMAGH PHYSICIAN ASSISTANT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7828 ZENITH DR UNIT 7011
CITRUS HEIGHTS CA
95621-2304
US

IV. Provider business mailing address

7828 ZENITH DR UNIT 7011
CITRUS HEIGHTS CA
95621-2304
US

V. Phone/Fax

Practice location:
  • Phone: 248-705-6345
  • Fax:
Mailing address:
  • Phone: 248-705-6345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: GURPREET SINGH SMAGH
Title or Position: CEO
Credential: PA
Phone: 248-705-6345