Provider Demographics
NPI:1235294752
Name:PHYSICIAN ASSISTANT SURGICAL SERVICES LTD.
Entity Type:Organization
Organization Name:PHYSICIAN ASSISTANT SURGICAL SERVICES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIUSTI
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:303-981-2981
Mailing Address - Street 1:8775 W OTTAWA AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4007
Mailing Address - Country:US
Mailing Address - Phone:303-981-2981
Mailing Address - Fax:303-932-0242
Practice Address - Street 1:8775 W OTTAWA AVE
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80128-4007
Practice Address - Country:US
Practice Address - Phone:303-981-2981
Practice Address - Fax:303-932-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO778363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty