| NPI | 1023733987 |
|---|---|
| Former Legal Business Name | CODET |
| Entity Type | Organization |
| Authorized Contact | SERGIO GROMAN Medical Surgeon 619-488-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |