| NPI | 1487854600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLIN G. SCHRIOCK Administrator 916-929-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2022-07-21 |