| NPI | 1528359304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETAR VUKASIN Owner 818-244-8161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA G74237) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G74237) |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2011-04-27 |