| NPI | 1013142280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN H FULLERTON Owner 415-202-9990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CA G59000) |
| Enumeration Date | 2009-05-18 |
| Last Update Date | 2014-10-30 |