| NPI | 1003136318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS LAWRENCE LEVIN Owner 530-889-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G36601) |
| Additional Taxonomies | 305S00000X Point of Service (Licence: CA G36601) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2010-06-09 |