| NPI | 1013050814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILMA CALDER Billing Mgr 707-246-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 959161) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 420034AP) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2017-12-08 |