| NPI | 1619517521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CANDICE LILLIAN BRADY Owner 805-273-5478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| Enumeration Date | 2020-01-08 |
| Last Update Date | 2026-01-23 |