| NPI | 1639282551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINGAGOUD MEMULA Administrator 510-818-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A698780) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A657720) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A81391) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A95318) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A81391) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4711) | |
| 363A00000X Physician Assistant (Licence: CA PA17256) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CA PA17256) | |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-10-18 |