| NPI | 1962589234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY ROBERT MACK Owner 858-715-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G37547) |
| Additional Taxonomies | 2086S0105X Surgery, Surgery of the Hand (Licence: CA G37547) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2017-09-22 |