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Organization
PERMANENTE MEDICAL GROUP
Active
Organization
PERMANENTE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BARRY SCURRAN (DPM)
(510) 987-4026
Entity
Organization
Contact information
Practice address
1955 COWELL BLVD, DAVIS, CA 95618-6325
(530) 757-4157
Mailing address
1955 COWELL BLVD, DAVIS, CA 95618-6325
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A49994
CA
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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