| NPI | 1932691797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY L BASSO Owner 916-235-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery Vascular Surgery |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2024-05-14 |