Provider Demographics
NPI:1295116051
Name:NORTHSTATE PLASTIC SURGERY ASSOCIATES INC
Entity type:Organization
Organization Name:NORTHSTATE PLASTIC SURGERY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBBARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-345-5900
Mailing Address - Street 1:PO BOX 8505
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95927-8505
Mailing Address - Country:US
Mailing Address - Phone:530-345-5900
Mailing Address - Fax:530-345-5995
Practice Address - Street 1:251 COHASSET RD
Practice Address - Street 2:SUITE 340
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-2241
Practice Address - Country:US
Practice Address - Phone:530-345-5900
Practice Address - Fax:530-345-5995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty