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General NPI Number Information
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NPI Number | 1902622426
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Entity Type | Organization
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Legal Business Name | PHYSICIAN ASSISTANT & ASSOCIATES INC
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Dates
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Enumeration Date | 11/30/2024
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Last Update Date | 11/30/2024
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Provider Practice Location Address
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Address Line | 11620 WILSHIRE BLVD STE 600
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City | LOS ANGELES
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State | CA
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Zip | 90025-1776
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Country | US
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Telephone | 909-742-5329
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Fax | 844-329-4373
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Provider Business Mailing Address
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Address Line | 11620 WILSHIRE BLVD STE 600
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City | LOS ANGELES
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State | CA
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Zip | 90025-1776
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Country | US
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Telephone | 909-742-5329
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Fax | 844-329-4373
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON URTIS
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Credential |
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Telephone | 832-578-9847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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