Eastern Sierra Urology Prof Corp

NPI #1760607790 in Bishop, California

Provider Information

NPI Number: 1760607790
Entity Type: Organization
Organization Name: Eastern Sierra Urology Prof Corp
Primary Specialty: Urology
Enumeration Date: Apr 16, 2007
Last Updated: Dec 14, 2010

Practice Location

Address: 152 PIONEER LN
Address 2: SUITE F
City: Bishop
State: California
ZIP Code: 93514-2563
Phone: (760) 872-1606

Authorized Official

Name: DR. TOMI L BORTOLAZZO, M.D.
Title: OWNER
Phone: (760) 872-1606

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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