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General NPI Number Information
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NPI Number | 1508702275
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Entity Type | Organization
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Legal Business Name | CLEARWATER ADVANCED SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 04/27/2026
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Last Update Date | 04/27/2026
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Provider Practice Location Address
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Address Line | 1281 E IRON EAGLE DR
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City | EAGLE
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State | ID
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Zip | 83616-6599
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Country | US
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Telephone | 208-900-8087
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Fax | 208-277-3873
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Provider Business Mailing Address
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Address Line | 1775 W STATE STREET PMB 361
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City | BOISE
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State | ID
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Zip | 83702
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Country | US
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Telephone | 208-900-8087
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Fax | 208-277-3783
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Authorized Official
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Title or Position | OWNER
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Name | DR. RASHNA GINWALLA
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Credential | MD
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Telephone | 215-901-4908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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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 |
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