| NPI | 1992104095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS JONES Billing Administrator 707-255-8825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: CA G73011) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2015-10-26 |