| NPI | 1316395395 |
|---|---|
| Doing Business As | DONALD WALDREP, MD |
| Entity Type | Organization |
| Authorized Contact | DONALD WALDREP Md / CEO 805-230-0030 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA G75982) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2024-03-29 |