| NPI | 1134302540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M HUIBONHOA Owner 510-204-0971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G77311) |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |