Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Copper State Hospital and Surgical

Organization Surgical Physician Assistant · NPI 1154746865

Copper State Hospital and Surgical is a Surgical Physician Assistant in Mesa, Arizona. Licensed in Arizona. Registered with an NPI since 2014.

Licensed in
AZ
In the registry since
2014

Practice location Address checks out

2852 S Carriage Ln
Mesa, AZ 85202-7801
Phone: (480) 706-9430
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 5596 (AZ)

Record details

NPI number1154746865
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official James Herzog — Owner · (480) 706-9430
NPI enumeratedMarch 4, 2014
Last updated in NPPESMarch 4, 2014
Mailing addressPo Box 40760, Mesa, AZ 85274-0760

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