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General NPI Number Information
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NPI Number | 1285431551
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Entity Type | Organization
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Legal Business Name | NORCAL MOBILE WOUND CARE A PHYSICIAN ASSISTANT CORPORATION
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 6520 LONETREE BLVD # 2009
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City | ROCKLIN
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State | CA
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Zip | 95765-5874
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Country | US
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Telephone | 916-661-4243
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Fax | 916-668-5828
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Provider Business Mailing Address
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Address Line | 10089 WILLOW CREEK RD STE 200
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City | SAN DIEGO
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State | CA
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Zip | 92131-1699
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Country | US
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Telephone | 916-661-4243
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Fax | 916-668-5828
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Authorized Official
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Title or Position | CEO
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Name | CHAD SPEARS
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Credential | PA
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Telephone | 916-661-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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