| 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 |