NPI | 1043623960 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHARD WIKHOLM Owner And Physician 805-614-9250 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA PA13405) |
Enumeration Date | 2014-06-09 |
Last Update Date | 2014-06-09 |