| NPI | 1053524793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HELEN ROEHLK Adm. Assist. Credentialing 209-385-5434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 030000519) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-08-22 |