| 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 | 207Y00000X Otolaryngology |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2020-09-24 |
| Last Update Date | 2020-09-24 |