| NPI | 1134092489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEWODROS TEKETEL Owner 510-258-7081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2025-09-24 |
| Last Update Date | 2025-10-31 |