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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