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General NPI Number Information
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NPI Number | 1730135773
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Entity Type | Organization
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Legal Business Name | OASIS SURGICAL PROF CORP
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 07/11/2007
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Provider Practice Location Address
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Address Line | 880 E TUOLUMNE RD SUITE 201
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City | TURLOCK
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State | CA
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Zip | 95382-1548
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Country | US
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Telephone | 209-632-2960
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Fax | 209-632-2062
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Provider Business Mailing Address
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Address Line | 880 E TUOLUMNE RD 201
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City | TURLOCK
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State | CA
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Zip | 95382-1548
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Country | US
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Telephone | 209-632-2960
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Fax | 209-632-2062
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Authorized Official
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Title or Position | CFO
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Name | DR. PAUL A CARMICHAEL
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Credential | MD
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Telephone | 209-632-2960
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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