| NPI | 1003022419 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS ENCHUL CHUNG CEO 408-293-7767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A54870) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A54870) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |