Advanced Surgical Physician Assistants, LLC
Physician Assistant, Surgical in Chandler, AZ. Organization (NPI-2).
NPI number1922419191
StatusActive
Last updated in NPPESJun 7, 2023
Details
- NPI
- 1922419191
- Entity type
- Organization (NPI-2)
- Legal business name
- Advanced Surgical Physician Assistants, LLC
- Organization subpart
- No
- Enumeration date
- May 9, 2014
- Certification date
- Jun 7, 2023
- Last updated
- Jun 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363AS0400X | Physician Assistant, Surgical | 3400 | AZ | Yes |
Practice location
2925 E Riggs RdSuite 8-114
Chandler, AZ 85249-3600
Phone 917-428-1003
Mailing address
2925 E Riggs RdSuite 8-114
Chandler, AZ 85249-3600
Phone 917-428-1003
Authorized official
Michael Anthony Chieco
Member
9174281003
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