Surgical Physician Assistant Services Incorporated

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

SURGICAL PHYSICIAN ASSISTANT SERVICES INCORPORATED

Practice address

839 Via Barquero
San Marcos, CA 92069-7395

Phone

(858) 349-1588

NPI assigned

Sep 10, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Peter Matthew Mazzarese, PA

Title

Owner

Phone

(858) 943-1588

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294185600000",
    "number": "1750530143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 VIA BARQUERO",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920697395",
            "telephone_number": "858-349-1588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "839 VIA BARQUERO",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920697395",
            "telephone_number": "858-349-1588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL PHYSICIAN ASSISTANT SERVICES INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-10",
        "last_updated": "2011-01-05",
        "status": "A",
        "authorized_official_last_name": "MAZZARESE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "858-943-1588",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in San Marcos, CA
• Providers in San Marcos, CA by specialty
• Surgical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2011; 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.