| NPI | 1376099747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON FRACH Billing Manager 408-984-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 51498) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |