| NPI | 1073764254 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUMBERTO JESUS VILLALVAZO President Md 559-898-0935 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A89926) |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2016-05-09 |