| NPI | 1801502679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SCRIVEN Credentialing 916-663-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2023-01-25 |
| Last Update Date | 2023-01-25 |