Organization
BONA FIDE SURGICAL ASSISTANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE DUQUE BARON PA-C (OWNER)
(909) 294-7329
Entity
Organization
Contact information
Practice address
274 W BADILLO ST, COVINA, CA 91723
(909) 294-7329
(909) 912-8631
Mailing address
310 N INDIAN HILL BLVD STE 526, CLAREMONT, CA 91711
(909) 294-7329
(909) 912-8631
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA 17201
CA
Other
Enumeration date
04/11/2016
Last updated
10/07/2022
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