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Organization
FORESTHILL MEDICAL CENTER INC
Active
Organization
FORESTHILL MEDICAL CENTER INC
Active
Other names
Blaise deSouza MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BLAISE PHILIP DESOUZA MD (PRESIDENT)
(530) 367-2229
Entity
Organization
Contact information
Practice address
23000 FORESTHILL RD, FORESTHILL, CA 95631
(530) 367-2229
(530) 367-4161
Mailing address
PO BOX 1040, FORESTHILL, CA 95631-1040
(530) 367-2229
(530) 367-4161
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
A37917
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5362017
—
CA
Enumeration date
05/04/2006
Last updated
08/22/2020
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