| NPI | 1225762917 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL A SHEA Owner 916-984-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2022-07-13 |