NPIMap

Organization Active NPI

Physician Assistant Specialists-California Inc

  • Surgical Physician Assistant
  • Rancho Santa Margarita, CA
National Provider Identifier
1245017185
Registry record updated Oct 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
Legal business name
PHYSICIAN ASSISTANT SPECIALISTS-CALIFORNIA INC
Practice address
22431 Antonio Pkwy # B160-613
Rancho Santa Margarita, CA 92688-2804
Phone
(855) 727-2251
Fax
(855) 727-2251
NPI assigned
Sep 13, 2023
Last updated
Oct 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2023

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

Authorized official

Name
Jeffrey BulgerNPI 1942245857
Title
President
Phone
(855) 727-2251

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X
Surgical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AS0400X Primary

Addresses

Primary practice location

22431 Antonio Pkwy # B160-613
Rancho Santa Margarita, CA 92688-2804

Mailing address

PO Box 101898
Pasadena, CA 91189-2804
Phone (855) 727-2251

Other practice location 1

1100 W Stewart Dr
Orange, CA 92868
Phone (855) 727-2251

Other practice location 2

27700 Medical Center Rd
Mission Viejo, CA 92691
Phone (855) 727-2251

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231222002130 CA Part B Supplier - Clinic/Group Practice 1355791997 Receives reassigned benefits from 12 practitioners
Practice locations: Rancho Santa Margarita, CA; Orange, CA; Mission Viejo, CA

National Provider Directory

National Provider Directory

Locations

8577 Haven Ave
Ste 300
Rancho Cucamonga, CA 91730

22431 Antonio Pkwy
#B160613
Rcho Sta Marg, CA 92688
Phone (833) 477-2677

Practitioners & affiliated clinicians

Practitioners 39

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1694563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696291200000",
    "number": "1245017185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 101898",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911892804",
            "telephone_number": "855-727-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22431 ANTONIO PKWY # B160-613",
            "city": "RANCHO SANTA MARGARITA",
            "state": "CA",
            "postal_code": "926882804",
            "telephone_number": "855-727-2251",
            "fax_number": "855-727-2251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 W Stewart Dr",
            "address_purpose": "LOCATION",
            "city": "Orange",
            "state": "CA",
            "postal_code": "92868",
            "country_code": "US",
            "telephone_number": "855-727-2251",
            "fax_number": "855-727-2251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27700 Medical Center Rd",
            "address_purpose": "LOCATION",
            "city": "Mission Viejo",
            "state": "CA",
            "postal_code": "92691",
            "country_code": "US",
            "telephone_number": "855-727-2251",
            "fax_number": "855-727-2251",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIAN ASSISTANT SPECIALISTS-CALIFORNIA INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-13",
        "last_updated": "2023-10-03",
        "certification_date": "2023-10-03",
        "status": "A",
        "authorized_official_last_name": "BULGER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-727-2251"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Santa Margarita, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.