| NPI | 1114126034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEHRI (MARY) MANSUBI Owner 408-358-2627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0201X Pediatrics, Pediatric Allergy/Immunology (Licence: CA A262890) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A330510) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2013-03-06 |