| NPI | 1326067208 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARRIE PAYNE Supervisor 209-525-3835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0102X Surgery, Surgical Critical Care |
| 2086S0127X Surgery, Trauma Surgery | |
| 2086S0129X Surgery, Vascular Surgery | |
| 208C00000X Colon & Rectal Surgery | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2008-01-11 |