Provider Demographics
NPI:1912688730
Name:SONORAN SURGICAL FIRST ASSIST LLC
Entity type:Organization
Organization Name:SONORAN SURGICAL FIRST ASSIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER/FIRST ASSIST
Authorized Official - Prefix:
Authorized Official - First Name:SAORI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKAGAWA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-227-2457
Mailing Address - Street 1:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75030-2550
Mailing Address - Country:US
Mailing Address - Phone:214-227-2457
Mailing Address - Fax:214-764-0880
Practice Address - Street 1:4735 E 3RD ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1240
Practice Address - Country:US
Practice Address - Phone:847-207-8091
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-25
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty