| NPI | 1447356290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WALDREP CEO 916-797-7555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA16323) |
| Enumeration Date | 2006-09-16 |
| Last Update Date | 2009-02-06 |