Ortho and Surgical 1St Assist

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11523 Issued in CA

Legal business name

ORTHO AND SURGICAL 1ST ASSIST

Practice address

250 S Grand Ave
Glendora, CA 91741-4218

Phone

(626) 938-7613

NPI assigned

Nov 11, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Rene Philippe Baquet, PA C

Title

Owner

Phone

(407) 328-0825

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226361600000",
    "number": "1972757490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 841",
            "city": "AZUSA",
            "state": "CA",
            "postal_code": "917020841",
            "telephone_number": "407-328-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 S GRAND AVE",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917414218",
            "telephone_number": "626-938-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHO AND SURGICAL 1ST ASSIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-11",
        "status": "A",
        "authorized_official_last_name": "BAQUET",
        "authorized_official_first_name": "RENE",
        "authorized_official_middle_name": "PHILIPPE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "407-328-0825",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA C"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA11523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Glendora, CA
• Providers in Glendora, 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 Nov 11, 2008; 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.