| NPI | 1932613759 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONIA SILVA Credentialing Manager 707-349-3509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E4707) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: CA E4707) |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2025-12-30 |