Pacific Advanced Surgical Services

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PACIFIC ADVANCED SURGICAL SERVICES

Practice address

191 Lynch Creek Way Ste 101
Petaluma, CA 94954-2389

Phone

(707) 495-9632

NPI assigned

Nov 2, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eric Bruntlett

Title

Coo

Phone

(707) 495-9632

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jason Edward Pope, MD

  • Pain Medicine (Anesthesiology) Physician
  • Santa Rosa, CA
  • NPI 1215078647
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667952000000",
    "number": "1144821752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 LYNCH CREEK WAY STE 101",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542389",
            "telephone_number": "707-495-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 LYNCH CREEK WAY STE 101",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542389",
            "telephone_number": "707-495-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ADVANCED SURGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2022-11-09",
        "certification_date": "2022-11-09",
        "status": "A",
        "authorized_official_last_name": "BRUNTLETT",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "707-495-9632"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Osbun
• Bradley Kimball Osgood, D.C.
• Farid Osman, MD
• Robert I Ostroff, M.D.
• Sierra M Overton
• Pacific Restorative Center
• Pacific Standard Physical Therapy, Incorporated
• Berenice Padilla-Perez
• Laura A Pajari
• Jesebel Amelia Palacios Lopez

• Ambulatory Surgical Clinic/Center in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.