| NPI | 1124213608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENAY JONES Office Manager 415-380-8448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G82105) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA G070541) |
| Enumeration Date | 2007-09-07 |
| Last Update Date | 2008-08-06 |