Organization
INTRALIGN CA PHYSICIAN ASSISTANTS INC
Active
Other names
John W. Cowan Physician Assistant Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATT BERTSCH (CFO)
(813) 343-5500
Entity
Organization
Contact information
Practice address
4002 VISTA WAY, OCEANSIDE, CA 92056-4506
(813) 343-5500
(813) 343-5506
Mailing address
PO BOX 21724, TAMPA, FL 33622-1724
(813) 343-5500
(813) 343-5506
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
CA
Other
Enumeration date
11/26/2007
Last updated
12/06/2016
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