| NPI | 1023736600 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRENT HOFMOCKEL COO 805-400-5232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 363AM0700X Physician Assistant Medical | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2023-06-29 |