| NPI | 1841039443 |
|---|---|
| Former Legal Business Name | PACIFIC GASTRO HEALTH |
| Entity Type | Organization |
| Authorized Contact | MEHDI FERDOWS Medical Director 360-823-0880 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-08-09 |