1922419191 NPI number — ADVANCED SURGICAL PHYSICIAN ASSISTANTS, LLC

Table of content: DR. PATRICK JOHN GOLDEN D.O. (NPI 1649408147)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922419191 NPI number — ADVANCED SURGICAL PHYSICIAN ASSISTANTS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED SURGICAL PHYSICIAN ASSISTANTS, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922419191
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2925 E RIGGS RD
Provider Second Line Business Mailing Address:
SUITE 8-114
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85249-3600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-428-1003
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2925 E RIGGS RD
Provider Second Line Business Practice Location Address:
SUITE 8-114
Provider Business Practice Location Address City Name:
CHANDLER
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85249-3600
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-428-1003
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/09/2014

Additional Information

Authorized Official

Authorized Official Last Name:
CHIECO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
ANTHONY
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
917-428-1003

Provider Taxonomy Codes

  • Taxonomy code: 363AS0400X , with the licence number:  3400 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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