Provider Demographics
NPI:1770964009
Name:SONORAN SURGICAL ASSISTING
Entity type:Organization
Organization Name:SONORAN SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAUDIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS-JACINTO
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C, LSA
Authorized Official - Phone:520-252-5452
Mailing Address - Street 1:67 S HIGLEY RD
Mailing Address - Street 2:103-228
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1166
Mailing Address - Country:US
Mailing Address - Phone:520-252-5452
Mailing Address - Fax:
Practice Address - Street 1:67 S HIGLEY RD
Practice Address - Street 2:103-228
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-1166
Practice Address - Country:US
Practice Address - Phone:520-252-5452
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCSA0124363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty