| NPI | 1245477454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD M SHERROD Officer 916-797-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A66088) |
| Additional Taxonomies | 111NR0400X (Licence: CA DC27169) |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2009-07-09 |