Provider Demographics
NPI:1770845455
Name:CALIFORNIA PHYSICIAN ASSISTANT STAFFING, INC.
Entity Type:Organization
Organization Name:CALIFORNIA PHYSICIAN ASSISTANT STAFFING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:661-742-7121
Mailing Address - Street 1:9530 HAGEMAN RD
Mailing Address - Street 2:SUITE B-204
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-3959
Mailing Address - Country:US
Mailing Address - Phone:661-742-7121
Mailing Address - Fax:661-589-2326
Practice Address - Street 1:9530 HAGEMAN RD
Practice Address - Street 2:SUITE B-204
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-3959
Practice Address - Country:US
Practice Address - Phone:661-742-7121
Practice Address - Fax:661-589-2326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-08
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA011069363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty