| NPI | 1104014935 |
|---|---|
| Doing Business As | SCVMC PHYSICIAN SERVICES |
| Entity Type | Organization |
| Authorized Contact | ALFONSO F BANUELOS Chief Medical Officer 4088-855-0000 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |