| NPI | 1922115575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN L RODRIGUEZ Financial Administrator 916-454-6677 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 363A00000X Physician Assistant | |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2018-08-21 |