| NPI | 1093884421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LAVIGNA Owner 510-465-1108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |