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Organization

ORTHO AND SURGICAL 1ST ASSIST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RENE PHILIPPE BAQUET PA C (OWNER)
(407) 328-0825
Entity
Organization

Contact information

Practice address
250 S GRAND AVE, GLENDORA, CA 91741-4218
(626) 938-7613
Mailing address
PO BOX 841, AZUSA, CA 91702-0841
(407) 328-0825

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA11523
CA

Other

Enumeration date
11/11/2008
Last updated
11/11/2008
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