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 |