| NPI | 1003305236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA DENICE COBB Office Supervisor/Billing Mgr 510-297-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G75352) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |