Organization
EMERGENCY NEUROSURGERY SERVICES MEDICAL GROUP, INC.
Active
Organization
EMERGENCY NEUROSURGERY SERVICES MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELINDA KOTKO (BILLER)
(916) 771-3393
Entity
Organization
Contact information
Practice address
1301 SECRET RAVINE PKWY, STE 200, ROSEVILLE, CA 95661-3096
(916) 771-3393
(916) 771-3445
Mailing address
1301 SECRET RAVINE PKWY, STE 200, ROSEVILLE, CA 95661-3096
(916) 771-3393
(916) 771-3445
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
G38223
CA
Other
Enumeration date
09/21/2009
Last updated
09/21/2009
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