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General NPI Number Information
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NPI Number | 1770845455
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Entity Type | Organization
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Legal Business Name | CALIFORNIA PHYSICIAN ASSISTANT STAFFING, INC.
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Dates
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Enumeration Date | 06/08/2012
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Last Update Date | 06/08/2012
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Provider Practice Location Address
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Address Line | 9530 HAGEMAN RD SUITE B-204
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City | BAKERSFIELD
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State | CA
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Zip | 93312-3959
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Country | US
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Telephone | 661-742-7121
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Fax | 661-589-2326
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Provider Business Mailing Address
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Address Line | 9530 HAGEMAN RD SUITE B-204
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City | BAKERSFIELD
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State | CA
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Zip | 93312-3959
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Country | US
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Telephone | 661-742-7121
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Fax | 661-589-2326
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | MR. STEPHEN HAROLD HANSON
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Credential | PA-C
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Telephone | 661-742-7121
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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 | PA011069
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License Number State | CA
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