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General NPI Number Information
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NPI Number | 1104585785
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Entity Type | Organization
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Legal Business Name | TORREY PINES PHYSICIAN ASSISTANT SURGICAL SERVICES, INC
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Dates
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Enumeration Date | 12/11/2021
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 6450 TOPMAST DR
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City | CARLSBAD
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State | CA
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Zip | 92011-1252
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Country | US
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Telephone | 949-632-5442
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Fax |
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Provider Business Mailing Address
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Address Line | 6450 TOPMAST DR
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City | CARLSBAD
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State | CA
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Zip | 92011-1252
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Country | US
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Telephone | 949-632-5442
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JENNIFER HANLEY
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Credential | PA-C
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Telephone | 949-632-5442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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