Provider Demographics
NPI:1285431551
Name:NORCAL MOBILE WOUND CARE A PHYSICIAN ASSISTANT CORPORATION
Entity type:Organization
Organization Name:NORCAL MOBILE WOUND CARE A PHYSICIAN ASSISTANT CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:SPEARS
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:916-661-4243
Mailing Address - Street 1:10089 WILLOW CREEK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1699
Mailing Address - Country:US
Mailing Address - Phone:916-661-4243
Mailing Address - Fax:916-668-5828
Practice Address - Street 1:6520 LONETREE BLVD # 2009
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5874
Practice Address - Country:US
Practice Address - Phone:916-661-4243
Practice Address - Fax:916-668-5828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty