| NPI | 1861014599 |
|---|---|
| Former Legal Business Name | SOUTHEN CALIFORNIA SURGICAL INC |
| Entity Type | Organization |
| Authorized Contact | JEFFREY WANNARES President 508-898-0986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |