| NPI | 1093979767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIENNE L MCGRAEL SOUDERS Owner 650-375-7706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA G048839) |
| Enumeration Date | 2008-07-11 |
| Last Update Date | 2008-07-11 |