| NPI | 1306317961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETE CARRASCO CEO 909-944-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 213E00000X Podiatrist |
| Enumeration Date | 2018-12-07 |
| Last Update Date | 2024-12-24 |