| NPI | 1073947305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN SAM DAVIDSON CEO 209-751-7165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA G66389) |
| Additional Taxonomies | 207RS0012X Internal Medicine Sleep Medicine (Licence: CA G66389) |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |