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NPI Code Detail

MEDICARE: SURGICAL PHYSICIAN ASSISTANTS, INC.

MEDICARE: SURGICAL PHYSICIAN ASSISTANTS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician Assistant11627CA
2363AS0400XSurgical Physician Assistant11518CA

General Provider Information

NPI Number : 1336113521
Entity Type Code : Organization
Provider Name (Legal Business Name) : SURGICAL PHYSICIAN ASSISTANTS, INC.
Provider Business Mailing Address
First Line : PO BOX 592
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-9692
Country : US
Telephone Number : 510-448-6772
Fax Number : 925-215-2251
Provider Business Practice Location Address
First Line : 350 HAWTHORNE AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94609-3108
Country : US
Telephone Number : 510-655-4000
Fax Number : 925-215-2251
Authorized Official
Title or Position : VICE-PRESIDENT
Name : MS. CATHERINE IRENE DUNNING
Credential : P.A.
Telephone Number : 510-448-6772
Provider Enumeration Date : 02/14/2006
Last Update Date : 08/22/2020

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Directions to “SURGICAL PHYSICIAN ASSISTANTS, INC. ” Practice Location

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