| NPI | 1679192108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY WARD Office Manager 805-648-3902 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-07-27 |