NPI | 1841623865 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN R SHACKFORD Owner/President 619-299-2600 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G29279) |
Additional Taxonomies | 208600000X Surgery (Licence: CA G29279) |
Enumeration Date | 2013-08-13 |
Last Update Date | 2013-08-13 |