| NPI | 1881197911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN WILLIS Office Manager 805-258-5420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 335E00000X Prosthetic/Orthotic Supplier |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2018-06-18 |