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General NPI Number Information
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NPI Number | 1093009482
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Entity Type | Organization
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Legal Business Name | FIRST ASSIST SURGICAL ASSOCIATES
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Dates
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Enumeration Date | 06/03/2011
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 221 BROOKE ACRES DR
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City | LOS GATOS
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State | CA
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Zip | 95032-6462
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Country | US
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Telephone | 408-656-9049
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Fax | 408-879-6204
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Provider Business Mailing Address
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Address Line | 405 SUNOL ST
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City | SAN JOSE
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State | CA
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Zip | 95126-3750
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Country | US
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Telephone | 408-656-9049
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Fax | 408-879-6204
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Authorized Official
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Title or Position | OWNER
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Name | KIRSTEN DUGGINS
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Credential |
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Telephone | 408-656-9049
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 257522-4568
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License Number State | CA
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