| NPI | 1548877590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASEY K LI Director 650-324-8376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 207Y00000X Otolaryngology | |
| 2086S0122X Surgery Plastic and Reconstructive Surgery | |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |