| NPI | 1740409721 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOUSHIN SHOAEE CFO 858-481-8240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery (Licence: CA A94751) |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4631) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |