| NPI | 1043609969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN VAUGHAN-WILLIAMS Executive Director 916-575-8851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 121528933) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |