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

Surgical Physician Assistant Specialist, Inc

Organization Exclusive Provider Organization · NPI 1619544178

Surgical Physician Assistant Specialist, Inc is an Exclusive Provider Organization in LA Mesa, California. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5555 Grossmont Center Dr
LA Mesa, CA 91942-3019
Phone: (619) 740-6000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Exclusive Provider Organization (primary) Taxonomy 302F00000X

Record details

NPI number1619544178
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Zachary Periharos — Owner · (530) 232-5985
NPI enumeratedJune 4, 2021
Last updated in NPPESJanuary 22, 2026
Certification dateJanuary 22, 2026
Mailing address1401 21st St # 11082, Sacramento, CA 95811-5226

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