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General NPI Number Information
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NPI Number | 1427366053
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Entity Type | Organization
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Legal Business Name | TOWNSEND SURGICAL SERVICES
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Dates
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Enumeration Date | 09/16/2010
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Last Update Date | 09/16/2010
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Provider Practice Location Address
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Address Line | 12979 MORENO BEACH DR SUITE 12303
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City | MORENO VALLEY
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State | CA
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Zip | 92555-4431
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Country | US
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Telephone | 760-668-6776
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Fax | 951-924-4700
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Provider Business Mailing Address
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Address Line | PO BOX 9367
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City | MORENO VALLEY
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State | CA
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Zip | 92552-9367
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Country | US
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Telephone | 760-668-6776
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Fax | 951-924-1320
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Authorized Official
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Title or Position | PRESIDENT
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Name | DEAN L TOWNSEND
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Credential | P.A.-C
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Telephone | 951-924-4700
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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 | PA16781
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License Number State | CA
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