Provider Demographics
NPI:1821553967
Name:ASSIST SURGICAL
Entity Type:Organization
Organization Name:ASSIST SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CABRERA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:310-860-3048
Mailing Address - Street 1:301 W BASTANCHURY RD STE 125
Mailing Address - Street 2:
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-3423
Mailing Address - Country:US
Mailing Address - Phone:949-743-5901
Mailing Address - Fax:949-544-0320
Practice Address - Street 1:301 W BASTANCHURY RD STE 125
Practice Address - Street 2:
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-3423
Practice Address - Country:US
Practice Address - Phone:949-743-5901
Practice Address - Fax:949-544-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-03
Last Update Date:2019-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPA20376OtherLICENSE