CENTENNIAL MEDICAL GROUP WEST LLC NPI 1063710192

NPI Information

  • NPI: 1063710192
  • Provider Name: CENTENNIAL MEDICAL GROUP WEST, LLC
  • Classification: Physician Assistant - 363AS0400X
  • Specialization: Surgical
  • Entity Type: Organization
  • Doing Business As: CENTENNIAL SURGICAL ASSISTANTS
  • Address: 2700 NW STEWART PKWY
    ROSEBURG, OR
    ZIP 97471
  • Phone: (541) 677-2494

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NPI Details

CENTENNIAL MEDICAL GROUP WEST, LLC is a surgical physician assistant in Roseburg, OR. CENTENNIAL MEDICAL GROUP WEST, LLC NPI is 1063710192. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Centennial Surgical Assistants.

The provider's business location address is:

2700 NW STEWART PKWY
ROSEBURG, OR
ZIP 97471-281
Phone: (541) 677-2494
Fax: (541) 677-2294

The provider's authorized official is Rahul Agarwal .
The authorized official title is President and has the following contact phone number (541) 677-2494.

The enumeration date for this NPI number is 3/15/2011 and was last updated on 3/15/2011.

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
1363AS0400XPhysician AssistantSurgicalYes

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: 11/21/2025

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