| NPI | 1093074221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNETTE DENISE DAULTON Owner 559-585-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: CA A34991) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2022-03-03 |