| NPI | 1720480031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MACRINA TORRES Billing Manager 408-984-2455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA51498) |
| Enumeration Date | 2014-09-17 |
| Last Update Date | 2014-09-17 |