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

Individual provider Surgical Physician Assistant · NPI 1366786204

Ignat Ivanov Ignatov, CSA is a Surgical Physician Assistant in Surprise, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2012
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Practice location Address checks out

13832 W Gelding Dr
Surprise, AZ 85379-8352
Phone: (602) 451-7496
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Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 4024 (AZ)

Record details

NPI number1366786204
Entity typeIndividual (Type 1)
GenderMale
Credentials CSA
Sole proprietorYes
NPI enumeratedNovember 15, 2012
Last updated in NPPESJanuary 4, 2023
Certification dateJanuary 4, 2023
Mailing address13832 W Gelding Dr, Surprise, AZ 85379-8352

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