| NPI | 1578850525 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON CHARLES FRACH Office/Billing Manager 408-984-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2011-07-05 |