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Organization
SEBASTOPOL ASC, L.P.
Active
Organization
SEBASTOPOL ASC, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC J KAHLE M.D. (CORPORATE OFFICER)
(707) 823-7628
Entity
Organization
Contact information
Practice address
6880 PALM AVE, SEBASTOPOL, CA 95472-4270
(707) 823-7628
(707) 823-1521
Mailing address
6880 PALM AVE, SEBASTOPOL, CA 95472-4270
(707) 823-7628
(707) 823-1521
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
010000189
CA
Other
Enumeration date
03/29/2007
Last updated
01/27/2012
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