| NPI | 1124791900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMIDELE OLATUNBOSUN President 510-407-4473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2021-09-27 |