| NPI | 1083748248 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMON RUSSELL KORB Director 408-358-1853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: CA A62686) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |