Organization
PACIFIC SURGICAL CORP.
Active
Other names
Pacific Surgical LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN EUGENE WHATLEY (CEO/PRINCIPLE OWNER)
(916) 548-1880
Entity
Organization
Contact information
Practice address
1110 W. KETTLEMAN LN., SUITE 21, LODI, CA 95240-6047
(209) 329-6443
(209) 365-6383
Mailing address
1110 W. KETTLEMAN LN., SUITE 21, LODI, CA 95240-6047
(209) 329-6443
(209) 365-6383
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
KH102259891
CA
Other
Enumeration date
01/20/2016
Last updated
01/20/2016
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