| NPI | 1609809144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURA STONHAM-STEFFENS Billing/Credentialing Supervisor 916-731-5955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0200X Ophthalmology, Ophthalmic Plastic and Reconstructive Surgery |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2022-01-17 |