| NPI | 1073931697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN RENEE DOMINIC Owner/Physician 559-246-4497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA G68190) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2014-04-01 |