| NPI | 1063559698 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGERY LACKMAN Chief Operating Officer 510-222-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA FNP 14657) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |