| NPI | 1003015843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYE LYNN BONHAM A VP, Managed Care 707-646-3289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2025-07-28 |