Organization · Type 2 NPI
4th Street Laser & Surgery Center Inc
Ambulatory Surgical Clinic/Center · Santa Rosa, CA
NPI number
1902964174
Active
Practice location
1720 4th St
Santa Rosa, CA 95404-3602
Fax (707) 544-6438
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ambulatory Surgical Clinic/Center Primary | 261QA1903X | 110000344 (CA) |
Ambulatory Surgical Clinic/Center: Definition to come...
Another provider at this address
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About NPI 1902964174
4th Street Laser & Surgery Center Inc's National Provider Identifier is 1902964174, issued on Dec 4, 2006. The primary taxonomy on file is Ambulatory Surgical Clinic/Center (261QA1903X), and the practice location is in Santa Rosa, CA. The record was last updated on Jan 17, 2013.