NPIMap

Organization Active NPI

Physician Assistant Surgassist, Inc.

  • Orthopaedic Surgery Physician
  • La Mesa, CA
National Provider Identifier
1235669268
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PHYSICIAN ASSISTANT SURGASSIST, INC.
Practice address
5555 Grossmont Center Dr
La Mesa, CA 91942-3019
Phone
(619) 740-6000
NPI assigned
Jun 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Authorized official

Name
Angel Anak-Agung-Gede, PA-C
Title
President
Phone
(951) 206-2347

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

5555 Grossmont Center Dr
La Mesa, CA 91942-3019

Mailing address

1250 Santa Cora Ave Apt 627
Chula Vista, CA 91913-1555
Phone (951) 206-2347

Other names 1

  • SurgAssist, Inc. Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1235669268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 SANTA CORA AVE APT 627",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919131555",
            "telephone_number": "951-206-2347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5555 GROSSMONT CENTER DR",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423019",
            "telephone_number": "619-740-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN ASSISTANT SURGASSIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-13",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "ANAK-AGUNG-GEDE",
        "authorized_official_first_name": "ANGEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "951-206-2347",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SurgAssist, Inc.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.