| NPI | 1023207149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENCITA DABU MASANGKAY Dent/Ownerist 510-741-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA 44028) |
| Enumeration Date | 2007-10-16 |
| Last Update Date | 2007-10-16 |