| NPI | 1043263189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM MOTSIFF CFO 408-795-3707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: CA 070000101) |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site (Licence: CA CLN 436) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-07-25 |