| NPI | 1245492321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLY A DEWALD Director Of Business Services 707-525-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2018-09-04 |