NPI | 1023065133 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN A MITNICK Medical Director 209-521-6097 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Additional Taxonomies | 207P00000X Emergency Medicine |
207R00000X Internal Medicine | |
207RN0300X Internal Medicine, Nephrology | |
207Y00000X Otolaryngology | |
Enumeration Date | 2006-05-27 |
Last Update Date | 2015-09-24 |