Organization
SIERRA WOUND CARE GROUP MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDEN L SMITH M.D. (M.D./DIRECTOR)
(209) 536-1785
Entity
Organization
Contact information
Practice address
12811 COVEY CIR, SONORA, CA 95370-5935
(209) 536-1785
(209) 536-1607
Mailing address
680 GUZZI LN, SUITE 201, SONORA, CA 95370-5288
(209) 536-1785
(209) 536-1607
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
05/13/2009
Last updated
05/13/2009
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