Organization
SPECIALTY CARE AND SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA R DHANDA M.D. (CEO)
70727798733
Entity
Organization
Contact information
Practice address
5685 MAIN ST, KELSEYVILLE, CA 95451-8945
(707) 279-8733
Mailing address
5685 MAIN ST, KELSEYVILLE, CA 95451-8945
(707) 279-8733
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G62526
CA
261QA1903X
Ambulatory Surgical Clinic/Center
2997
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G62526
THE MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
01/26/2015
Last updated
01/26/2015
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