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YASSA PAC LLC NPI 1962016360


NPI Information

NPI: 1962016360
Provider Name: YASSA PAC LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
624 E 9 MILE RD
HAZEL PARK, MI
ZIP 48030
Phone: (248) 629-7497
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YASSA PAC LLC is a clinic center in Hazel Park, MI. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). YASSA PAC LLC NPI is 1962016360. The provider is registered as an organization entity type.

The provider's business location address is:

624 E 9 MILE RD
HAZEL PARK, MI
ZIP 48030-842
Phone: (248) 629-7497

The provider's authorized official is Marcos Yassa .
The authorized official title is Pa-c and has the following contact phone number (248) 629-7497.

The enumeration date for this NPI number is 9/2/2020 and was last updated on 12/16/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/CenterYes
2363A00000XPhysician AssistantNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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