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General NPI Number Information
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NPI Number | 1295238442
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Entity Type | Organization
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Legal Business Name | NORTHERN CALIFORNIA INTEGRATED SURGEONS, MEDICAL CORPORATION
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 2750 ROHRER DR
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City | LAFAYETTE
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State | CA
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Zip | 94549-5753
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Country | US
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Telephone | 520-907-4776
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Fax |
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Provider Business Mailing Address
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Address Line | 2750 ROHRER DR
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City | LAFAYETTE
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State | CA
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Zip | 94549-5753
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE
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Name | MR. JOHN FRIEND
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Credential |
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Telephone | 520-907-4776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number |
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License Number State |
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