Individual provider · Type 1 NPI

Stephanie E. Pongracz, PA

Surgical Physician Assistant · Santa Monica, CA

NPI number 1508172016 Active

Practice location

2020 Santa Monica Blvd, Suite 400
Santa Monica, CA 90404-2023

Call (310) 928-2663 Map

Fax (310) 315-2198

Mailing address

1658 Camden Ave, No 105
Los Angeles, CA 90025-7548

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA20968 (CA)

Surgical Physician Assistant: Definition to come...

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About NPI 1508172016

Stephanie E. Pongracz, PA's National Provider Identifier is 1508172016, issued on Aug 20, 2010. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Santa Monica, CA. The record was last updated on Dec 9, 2014.