| NPI | 1588635288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD L. RACEK Owner 619-482-0082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA 002702-06) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2013-10-28 |