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 |