| NPI | 1003985037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER SHOUP Administrative Assistant 831-464-9962 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2013-08-07 |