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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