Organization
YASSA PAC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCOS YASSA (PA-C)
(248) 629-7497
Entity
Organization
Contact information
Practice address
624 E 9 MILE RD, HAZEL PARK, MI 48030-1842
(248) 629-7497
Mailing address
PO BOX 366, HAZEL PARK, MI 48030-0366
(248) 629-7497
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/02/2020
Last updated
12/16/2020
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