Organization
GM SURGICAL ASSISTANT INC
Active
Other names
GM Surgical Assistant Inc
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER SEVILLA (BILLING ADMIN)
(909) 346-0807
Entity
Organization
Contact information
Practice address
15615 TURNBERRY ST, MORENO VALLEY, CA 92555-4901
(951) 992-6201
Mailing address
15615 TURNBERRY ST, MORENO VALLEY, CA 92555-4901
(951) 992-6201
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA22985
CA
Other
Enumeration date
01/02/2018
Last updated
01/02/2018
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